| NPI | 1407026453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE MILTICH LYST Owner 615-790-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 2760) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2008-03-05 |