| NPI | 1730374372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE DICKERSON Practice Manager 901-757-0568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN B04332) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: TN P0000002344) |
| 103TC1900X Psychologist, Counseling (Licence: TN P0000001065) | |
| 1041C0700X Social Worker, Clinical (Licence: TN LSW0000004111) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN Q14401) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN P91022) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2014-08-28 |