| NPI | 1649830423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN CONDON Office Manager 423-790-4906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2023-03-01 |