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118 Lee Parkway Dr Ste 180 Chattanooga TN 37421-1761 | |
| (423) 403-4393 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 118 Lee Parkway Dr Ste 180, Chattanooga, Tennessee |
| Authorized Official Name and Position | Lar'mara N. Henderson (OWNER) |
| Authorized Official Contact | 3018734360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9301 Ocoee St Unit 85 Ooltewah TN 37363-7723 Ph: (423) 403-4393 | 118 Lee Parkway Dr Ste 180 Chattanooga TN 37421-1761 Ph: (423) 403-4393 |
| NPI Number | 1932820891 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 09/07/2023 |
| Certification Date | 09/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932820891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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