Individual
MATTHEW LUKE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
204 N MAIN ST STE 6, DICKSON, TN 37055-1815
(615) 988-8823
Mailing address
204 N MAIN ST STE 6, DICKSON, TN 37055-1815
(615) 988-8823
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
921236194
LLC
TN
Enumeration date
12/07/2022
Last updated
12/07/2022
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