| NPI | 1699198895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE MILTICH LYST Clinical Director 615-550-3560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 45603) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 2760) |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2014-01-24 |