Organization
PEDIATRIC ADOLESCENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA RENEA HALL (FRONT DESK MANAGER)
(901) 757-3520
Entity
Organization
Contact information
Practice address
882 WILLOW TREE CIR STE 201, CORDOVA, TN 38018-3118
(901) 757-3520
(901) 737-3807
Mailing address
882 WILLOW TREE CIR STE 201, CORDOVA, TN 38018-3118
(901) 757-3520
(901) 737-3807
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2676
TN
Other
Enumeration date
05/31/2007
Last updated
08/22/2020
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