| NPI | 1952820896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANA CAROL FERGUSON Owner 865-603-8575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 6047) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2019-08-26 |