Full Name | |
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Speciality | Counselor - Mental Health |
Location | 214 Main St, Baxter, Tennessee |
Authorized Official Name and Position | Elisa Allen (FOUNDER) |
Authorized Official Contact | 9313195348 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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11145 Pete Carr Ridge Rd Silver Point TN 38582-6278 Ph: () - | 214 Main St Baxter TN 38544-5280 Ph: (931) 588-0475 |
NPI Number | 1376046425 |
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Provider Enumeration Date | 03/15/2018 |
Last Update Date | 03/15/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376046425 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |