Organization
AUDAX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEISHA DOVER (OWNER)
(865) 230-3919
Entity
Organization
Contact information
Practice address
4010 DUTCH VALLEY RD, CLINTON, TN 37716-5505
(865) 230-3919
Mailing address
4010 DUTCH VALLEY RD, CLINTON, TN 37716-5505
(865) 230-3919
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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