| NPI | 1508895764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE STOVALL Office Manager 901-767-1136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2013-07-31 |