Organization
ETSU BEHAVIORAL HEALTH AND WELLNESS CLINIC
Active
Organization
ETSU BEHAVIORAL HEALTH AND WELLNESS CLINIC
Active
Parent organization
EAST TENNESSEE STATE UNIVERSITY
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST TENNESSEE STATE UNIVERSITY
Authorized official
DR. KERRY L. HOLLAND PH.D. (CLINIC DIRECTOR)
(423) 439-7777
Entity
Organization
Contact information
Practice address
807 UNIVERSITY PKWY, 139 LUCILLE CLEMENT HALL, JOHNSON CITY, TN 37614-6500
(423) 439-7777
(423) 439-7780
Mailing address
807 UNIVERSITY PARKWAY, CAMPUS BOX 70416, 139 LUCILLE CLEMENT HALL, JOHNSON CITY, TN 37614
(423) 439-7777
(423) 439-7780
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
9378
TN
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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