Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | PE0000000616 | TN |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PE0000000616 | TN |
N | 103TM1800X | Intellectual & Developmental Disabilities | PE0000000616 | TN |
N | 103TS0200X | School Psychologist | PE0000000616 | TN |
NPI | 1811190952 |
---|---|
Provider Name | Mr. William Forrest Rymer |
First Address | Greeneville, TN 37744-1341 |
Second Address | Greeneville, TN 37745-7022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 08/07/2007 |