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1104 Tusculum Blvd Ste 215 Greeneville TN 37745-4091 | |
| (423) 783-7995 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1104 Tusculum Blvd Ste 215, Greeneville, Tennessee |
| Authorized Official Name and Position | Heather Colleen Gow (PSYCHOLOGIST) |
| Authorized Official Contact | 4237837995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1104 Tusculum Blvd Ste 215 Greeneville TN 37745-4091 Ph: (423) 783-7995 | 1104 Tusculum Blvd Ste 215 Greeneville TN 37745-4091 Ph: (423) 783-7995 |
| NPI Number | 1235506353 |
|---|---|
| Provider Enumeration Date | 08/24/2015 |
| Last Update Date | 05/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235506353 | NPI | - | NPPES |
| 1526146 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | P0000002836 (Tennessee) | Primary |
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