Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003080573 |
---|---|
Provider Name | Hazel F Brady |
First Address | Knoxville, TN 37919-7315 |
Second Address | Knoxville, TN 37919-7315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 16/04/2008 |