| NPI | 1205265410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JACOB WILLIAMS Owner 865-525-1099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 2951) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MA 8856) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2013-11-07 |