| NPI | 1730796533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA E ROSS Credentialing 615-570-9959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2022-06-24 |