Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1154774941 |
---|---|
Provider Name | Mr. Andrew Harper |
First Address | Knoxville, TN 37921-6253 |
Second Address | Knoxville, TN 37921-6253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2016 |
Last Update Date | 18/07/2016 |