| NPI | 1902271398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELANE LOUIS DAVIS Billing Manager 423-315-3063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TN LPC2637) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |