Individual
PHYLICIA KOURTNEY NATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1535 N MOUNT JULIET RD, MT JULIET, TN 37122-3315
(615) 560-6622
Mailing address
1405 RIVERWATCH CT APT 4315, MURFREESBORO, TN 37128-1715
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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