| NPI | 1154209583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMPBELL O'NEAL REYNOLDS Owner 865-617-8057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |