Healthcare Provider Details

I. General information

NPI: 1003710096
Provider Name (Legal Business Name): ANNA HOLZMACHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 THORNTON TAYLOR PKWY STE B
FAYETTEVILLE TN
37334-3669
US

IV. Provider business mailing address

2270 THORNTON TAYLOR PKWY STE B
FAYETTEVILLE TN
37334-3669
US

V. Phone/Fax

Practice location:
  • Phone: 615-669-6397
  • Fax: 615-992-3933
Mailing address:
  • Phone: 615-669-6397
  • Fax: 615-992-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2413
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: