| NPI | 1467135483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY FISK Marriage And Family Therapist 615-200-7821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2024-07-24 |