Organization
MAGNOLIA HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERA MARIE CAMPBELL (OWNER)
(910) 849-5517
Entity
Organization
Contact information
Practice address
1101 NIGHT CAP LN, KNOXVILLE, TN 37919-8746
(912) 660-1547
Mailing address
1101 NIGHT CAP LN, KNOXVILLE, TN 37919-8746
(912) 660-1547
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/31/2023
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