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General NPI Number Information
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NPI Number | 1275031155
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Entity Type | Individual
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Provider Name | TATIANA NOGUEIRA PEREDO PHD
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Gender | Female
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 2200 21ST AVE S STE 300
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City | NASHVILLE
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State | TN
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Zip | 37212-4929
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Country | US
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Telephone | 615-378-7182
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Fax |
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Provider Business Mailing Address
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Address Line | 203 S 15TH ST
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City | NASHVILLE
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State | TN
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Zip | 37206-2853
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Country | US
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Telephone | 901-826-9712
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4066
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License Number State | TN
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