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General NPI Number Information
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NPI Number | 1225362429
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Entity Type | Organization
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Legal Business Name | TRANSFORMATIONAL MANAGEMENT GROUP, LLC
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 2120 CRESTMOOR RD SUITE 3016
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City | NASHVILLE
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State | TN
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Zip | 37215-2654
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Country | US
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Telephone | 615-397-9796
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Fax | 615-250-8457
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Provider Business Mailing Address
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Address Line | 2120 CRESTMOOR RD SUITE 3016
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City | NASHVILLE
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State | TN
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Zip | 37215-2654
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Country | US
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Telephone | 615-397-9796
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Fax | 615-250-8457
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DOUGLAS R HERR
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Credential | PSY.D.
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Telephone | 615-397-9796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P2368
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License Number State | TN
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