| NPI | 1780201442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY CYR Member 931-581-1502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-07-14 |