| NPI | 1790423366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CALVIN HAWTHORNE President 865-584-0171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103G00000X Clinical Neuropsychologist | |
| 103T00000X Psychologist | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 1041C0700X Social Worker Clinical | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2024-09-12 |