| NPI | 1154510394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN M MICKLES Owner/Mental Health Therapist 615-853-1254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 57) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health (Licence: NE 1485) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2015-09-28 |