Healthcare Provider Details

I. General information

NPI: 1063598159
Provider Name (Legal Business Name): ANN D GWIN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN GWIN HASKETT L.C.S.W.

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 21ST AVE S SUITE 302
NASHVILLE TN
37212-4927
US

IV. Provider business mailing address

1060 TODD PREIS DR
NASHVILLE TN
37221-2478
US

V. Phone/Fax

Practice location:
  • Phone: 615-646-7237
  • Fax: 615-673-7749
Mailing address:
  • Phone: 615-646-7237
  • Fax: 615-673-7749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0000000850
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: