| NPI | 1942568019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | K. SHANNON WILSON President 865-584-4005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P2498) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2012-04-26 |