| NPI | 1356715445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT LEE NICHOLS Owner 901-388-1893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P866) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: TN P866) |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2018-08-08 |