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General NPI Number Information
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NPI Number | 1447174412
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Entity Type | Organization
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Legal Business Name | MID-SOUTH FAMILY THERAPY PLLC
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 1324 TROTWOOD AVE STE 6
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City | COLUMBIA
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State | TN
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Zip | 38401-4750
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Country | US
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Telephone | 615-637-3746
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 282
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City | THOMPSONS STATION
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State | TN
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Zip | 37179-0282
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL FERRELL HAILE
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Credential |
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Telephone | 615-604-0630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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