Eagles Passage Therapeutic Farm, LLC
NPI #1427200757 in New Market, Tennessee
Provider Information
- NPI Number
- 1427200757
- Entity Type
- Organization
- Organization Name
- Eagles Passage Therapeutic Farm, LLC
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Oct 17, 2008
- Last Updated
- Dec 9, 2010
Practice Location
- Address
- 2605 RIDDLE RD
- City
- New Market
- State
- Tennessee
- ZIP Code
- 37820-4835
- Phone
- (865) 932-3331
Authorized Official
- Name
- LISA LYNN FRADY, LCSW
- Title
- MEMBER/CLINICAL DIRECTOR
- Phone
- (865) 932-3331
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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