| NPI | 1043702814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UMIECA NICOLLE HANKTON Licensed Clinical Psychologist 901-300-9082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 1456) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2025-05-14 |