| NPI | 1710444310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIANNA L BODDY Owner 865-983-1899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2025-05-12 |