| NPI | 1902117815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEENA BOLTON Owner 901-672-7134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-06-24 |