| NPI | 1356617401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEPPER B PRATT Partner 731-660-0199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |