Healthcare Provider Details

I. General information

NPI: 1427388107
Provider Name (Legal Business Name): MAX LOUIS GUNTHER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2010
Last Update Date: 01/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

783 SAUSSY PL
NASHVILLE TN
37205-3021
US

IV. Provider business mailing address

783 SAUSSY PL
NASHVILLE TN
37205-3021
US

V. Phone/Fax

Practice location:
  • Phone: 615-829-6294
  • Fax:
Mailing address:
  • Phone: 615-829-6294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2880
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2880
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2880
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: