Provider Demographics
NPI:1194875104
Name:ABERCROMBIE, MARIA (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 CHADWICK DRIVE
Mailing Address - Street 2:SUITE 152
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5288
Mailing Address - Country:US
Mailing Address - Phone:615-972-5333
Mailing Address - Fax:865-671-2645
Practice Address - Street 1:7003 CHADWICK DRIVE
Practice Address - Street 2:SUITE 152
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5288
Practice Address - Country:US
Practice Address - Phone:615-972-5333
Practice Address - Fax:865-671-2645
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1024103TC0700X
TNP0000001024103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3684377Medicaid
TNR68716Medicare PIN
TN3684377Medicaid