| NPI | 1396344784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ERIC BRUNO Practice Administration 901-446-0226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-10-18 |
| Last Update Date | 2021-01-13 |