Organization
LANTERN LANE FARM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH COOK LMFT (CEO)
(615) 584-6959
Entity
Organization
Contact information
Practice address
6201 CORINTH RD, MOUNT JULIET, TN 37122-7603
(615) 584-6959
Mailing address
6201 CORINTH RD, MOUNT JULIET, TN 37122-7603
(615) 584-6959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5836
TN
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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