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General NPI Number Information
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NPI Number | 1740485945
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Entity Type | Organization
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Legal Business Name | THE DEMESSO GROUP LLC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1514 UNDERWOOD ST
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City | NASHVILLE
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State | TN
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Zip | 37208
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Country | US
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Telephone | 615-327-0728
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Fax | 615-327-0282
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Provider Business Mailing Address
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Address Line | PO BOX 282302
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City | NASHVILLE
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State | TN
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Zip | 37228-8514
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Country | US
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Telephone | 615-327-0728
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Fax | 615-327-0282
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Authorized Official
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Title or Position | CEO
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Name | MR. D B FULLER
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Credential |
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Telephone | 615-327-0728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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