| NPI | 1306315734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM JUDKINS Practice Admin/Authorized Official 865-579-2694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2021-08-10 |