| NPI | 1649830423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN M CONDON Office Manager 423-790-4906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2024-08-14 |