Organization
REFORM PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEMIMA MENSAH PMHNP (OWNER)
(207) 530-0461
Entity
Organization
Contact information
Practice address
433 NISSAN DR STE 301, SMYRNA, TN 37167
(615) 751-0347
(615) 249-5162
Mailing address
433 NISSAN DR STE 301, SMYRNA, TN 37167-4360
(615) 751-0347
(615) 249-5162
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q049227
—
TN
Enumeration date
04/16/2019
Last updated
07/01/2019
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