Organization · NPI-2

17th Avenue Psychiatry

Psychiatry & Neurology, Child & Adolescent Psychiatry · Nashville, TN

NPI number1619154440
StatusActive
Last updated in NPPESJan 23, 2008

Details

NPI
1619154440
Entity type
Organization (NPI-2)
Legal business name
17th Avenue Psychiatry
Organization subpart
No
Enumeration date
Jan 23, 2008
Last updated
Jan 23, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry38217TNYes

Practice location

1503 17th Ave S
Nashville, TN 37212-2805

Phone 615-292-1664

Mailing address

Po Box 40466
Nashville, TN 37204-0466

Authorized official

Frederick Starr
Ceo
6152921664

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