Organization
FAMILY WELLNESS CENTER OF CLARKSVILLE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANICE D MARTIN PH.D. (CEO)
(931) 552-4171
Entity
Organization
Contact information
Practice address
1891 OLD TRENTON RD, CLARKSVILLE, TN 37040-6734
(931) 552-4171
(931) 551-9485
Mailing address
PO BOX 30429, CLARKSVILLE, TN 37040-0008
(931) 552-4171
(931) 551-9485
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1717
TN
103TC0700X
Clinical Psychologist
Primary
2046
TN
103TC0700X
Clinical Psychologist
263
TN
1041C0700X
Clinical Social Worker
611
TN
2084P0800X
Psychiatry Physician
16723
TN
Other
Enumeration date
12/20/2008
Last updated
12/20/2008
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