| NPI | 1770651598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN PARKS WAGNER Secretary 865-212-5301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN P0000000600) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TN P0000001265) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |