Organization
RENEW AHAVA THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN GRAY LCSW (OWNER)
(901) 513-7084
Entity
Organization
Contact information
Practice address
3340 POPLAR AVE STE 205, MEMPHIS, TN 38111-4680
(901) 513-7084
Mailing address
3340 POPLAR AVE STE 205, MEMPHIS, TN 38111-4680
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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