Healthcare Provider Details

I. General information

NPI: 1164370714
Provider Name (Legal Business Name): ANNA NEWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 P POOLE AVE APT 203
CHATTANOOGA TN
37415-5783
US

IV. Provider business mailing address

101 P POOLE AVE APT 203
CHATTANOOGA TN
37415-5783
US

V. Phone/Fax

Practice location:
  • Phone: 423-703-9124
  • Fax: 833-708-7537
Mailing address:
  • Phone: 423-703-9124
  • Fax: 833-708-7537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-307795
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: