| NPI | 1912026188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY ALTFELD Executive Director 731-394-0749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN PE000000388) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |