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General NPI Number Information
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NPI Number | 1205937802
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY ALTERNATIVES, PLLC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 02/09/2012
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Provider Practice Location Address
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Address Line | 101 JORDAN DR
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6732
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Country | US
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Telephone | 423-510-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 101 JORDAN DR
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6732
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Country | US
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Telephone | 423-510-1999
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. LAURA SCHREEDER HUBONA
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Credential | LCSW
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Telephone | 423-510-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4272
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License Number State | TN
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