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General NPI Number Information
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NPI Number | 1700675063
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Entity Type | Organization
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Legal Business Name | DUSK THERAPY LLC
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Dates
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Enumeration Date | 05/03/2025
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Last Update Date | 05/03/2025
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Provider Practice Location Address
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Address Line | 1222 TREMONT ST STE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37405-3038
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Country | US
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Telephone | 423-225-2217
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Fax |
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Provider Business Mailing Address
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Address Line | 1728 BAILEY AVE APT 302
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3095
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Country | US
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Telephone | 423-225-2217
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY MILLER
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Credential | M.ED.
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Telephone | 423-987-4748
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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 |
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License Number State |
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