Individual
RONALD SURGEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP-MHSP TEMP
Contact information
Practice address
240 MADISON AVE, MEMPHIS, TN 38103-2767
(901) 860-4214
Mailing address
6363 POPLAR AVE STE 404, MEMPHIS, TN 38119-4831
(866) 762-8835
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/30/2019
Last updated
05/30/2019
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