Organization
YOUTH VILLAGES
Active
Organization
YOUTH VILLAGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VONDA KARLA WAGNER M.A. (FAMILY COUNSELOR)
(423) 283-6517
Entity
Organization
Contact information
Practice address
3915 BRISTOL HWY, SUITE 202, JOHNSON CITY, TN 37601-1400
(423) 283-6500
Mailing address
3915 BRISTOL HWY, SUITE 202, JOHNSON CITY, TN 37601-1400
(423) 283-6500
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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