Organization
ILLUMINATE PSYCHOTHERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDY GILLIAM (ADMINISTRATIVE EXPERT)
(423) 510-1999
Entity
Organization
Contact information
Practice address
101 JORDAN DR, CHATTANOOGA, TN 37421-6732
(423) 510-1999
Mailing address
101 JORDAN DR, CHATTANOOGA, TN 37421-6732
(423) 510-1999
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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