Organization
TRI-CITIES EATING DISORDER THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHALEEN BLAKE LPC (OWNER, THERAPIST)
(423) 708-6982
Entity
Organization
Contact information
Practice address
2700 S ROAN ST STE 203, JOHNSON CITY, TN 37601-7557
(423) 708-6982
Mailing address
2700 S ROAN ST STE 203, JOHNSON CITY, TN 37601-7557
(423) 708-6982
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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