Individual
IDA PATRICE TRULY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
717 HART LN, NASHVILLE, TN 37216-2007
(615) 460-4290
Mailing address
717 HART LN, NASHVILLE, TN 37216-2007
(615) 460-4290
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
247200000X
Other Technician
Primary
—
—
374700000X
Technician
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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