Organization
DR. MARY WANAT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY WANAT PHD (OWNER)
(901) 756-8398
Entity
Organization
Contact information
Practice address
8820 TRINITY RD STE 200, CORDOVA, TN 38018-2735
(901) 385-2342
(901) 382-0140
Mailing address
8820 TRINITY RD STE 200, CORDOVA, TN 38018-2735
(901) 385-2342
(901) 382-0140
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P2041
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3064204
BCBS
TN
Enumeration date
06/11/2013
Last updated
06/11/2013
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