Mountain States Health Alliance Out-Patient Behavioral Health

NPI #1083936033 in Kingsport, Tennessee

Provider Information

NPI Number: 1083936033
Entity Type: Organization
Organization Name: Mountain States Health Alliance Out-Patient Behavioral Health
Primary Specialty: Psychologist - Health Service
Enumeration Date: Feb 18, 2010
Last Updated: Feb 18, 2010

Practice Location

Address: 2012 BROOKSIDE DR
City: Kingsport
State: Tennessee
ZIP Code: 37660-4645
Phone: (423) 857-5566

Authorized Official

Name: GRACIELA PEREIRA
Title: AVP BEHAVIORAL HEALTH AND REHAB SER
Phone: (423) 952-1701

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Health Service — Health Service	103TH0100X	Primary

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