Organization
STATE OF TENNESSEE
Active
Other names
West Tennessee Resource Center
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH EDWARDS (DEPUTY DIRECTOR)
(901) 745-7352
Entity
Organization
Contact information
Practice address
11437 MILTON WILSON RD, ARLINGTON, TN 38002
(901) 745-7352
(901) 745-7379
Mailing address
11437 MILTON WILSON RD, ARLINGTON, TN 38002
(901) 745-7352
(901) 745-7379
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
122300000X
Dentist
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
02/11/2011
Last updated
02/11/2011
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