Organization
MINDS MATTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRANCE PAGE BS INFORMATION SYS (MEMBER)
(931) 561-5252
Entity
Organization
Contact information
Practice address
118 MEDICAL CT, CLARKSVILLE, TN 37043-4602
(931) 408-9909
Mailing address
118 MEDICAL CT, CLARKSVILLE, TN 37043-4602
(931) 408-9909
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/25/2019
Last updated
05/03/2023
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