| NPI | 1114260486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN DICKSON SHAW Therapist 901-570-0556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AR 5606c) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2025-04-24 |