| NPI | 1609424274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA CABAGE Owner 865-724-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2022-05-16 |