Individual
ANDREW WILLIAM DIPASTENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT TEMP LICENSE
Contact information
Practice address
2200 CHAMBLISS AVE NW, CLEVELAND, TN 37311-3874
(423) 599-9347
Mailing address
725 EVERHART DR NW, CLEVELAND, TN 37311-1622
(423) 544-0199
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1914
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/07/2022
Last updated
11/22/2023
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