Healthcare Provider Details

I. General information

NPI: 1972537454
Provider Name (Legal Business Name): ALLISON ANNE HASTINGS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 N JACKSON ST
TULLAHOMA TN
37388-2343
US

IV. Provider business mailing address

PO BOX 640
MCMINNVILLE TN
37111-0640
US

V. Phone/Fax

Practice location:
  • Phone: 931-455-6213
  • Fax: 931-455-6225
Mailing address:
  • Phone: 931-507-1212
  • Fax: 931-507-1217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS35440
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number7133
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: