Healthcare Provider Details

I. General information

NPI: 1326826884
Provider Name (Legal Business Name): ANNA MELDAHL LPC - MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3309 CUMMINGS HWY
CHATTANOOGA TN
37419-2376
US

IV. Provider business mailing address

3309 CUMMINGS HWY
CHATTANOOGA TN
37419-2376
US

V. Phone/Fax

Practice location:
  • Phone: 423-933-2575
  • Fax:
Mailing address:
  • Phone: 423-933-2575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: