| NPI | 1962948554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD STEVEN MCDONALD Registered Agent 423-509-8765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TN 6443) |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2023-05-31 |