| NPI | 1063048668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA M MALADY Credentialing 901-737-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-03-16 |