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NPI Code Detail

MEDICARE: MRS. HANLEY TESTERMAN ROACH LMFT

MEDICARE:  MRS. HANLEY TESTERMAN ROACH  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist1336TN

General Provider Information

NPI Number : 1861037657
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HANLEY TESTERMAN ROACH LMFT
Provider Business Mailing Address
First Line : 111 FOREST CT
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-5078
Country : US
Telephone Number : 865-588-9919
Fax Number : 865-909-0422
Provider Business Practice Location Address
First Line : 111 FOREST CT
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-5078
Country : US
Telephone Number : 865-588-9919
Fax Number : 865-909-0422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2019
Last Update Date : 11/15/2019

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Directions to “ MRS. HANLEY TESTERMAN ROACH LMFT” Practice Location

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