| NPI | 1437357456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY CLEMENTS GASTON Chief Manager 423-486-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: TN 377) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TN 2774) |
| 2251P0200X Physical Therapist Pediatrics (Licence: TN 1422) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: TN 2655) | |
| 225XP0200X Occupational Therapist Pediatrics (Licence: TN 2796) | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2014-03-05 |