MEDICARE: ALLIED HEALTH PROFESSIONALS

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
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1881196376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIED HEALTH PROFESSIONALS

Provider Business Mailing Address
First Line	:	3056 HORN SPRINGS ROAD
Second Line	:
City	:	LEBANON
State	:	TX
Zip	:	37087-1953
Country	:	US
Telephone Number	:	615-552-3234
Fax Number	:	615-449-3590

Provider Business Practice Location Address
First Line	:	3056 HORN SPRINGS ROAD
Second Line	:
City	:	LEBANON
State	:	TX
Zip	:	37087-1953
Country	:	US
Telephone Number	:	615-552-3234
Fax Number	:	615-449-3590

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES LEWIS PROFFITT II
Credential	:
Telephone Number	:	615-552-3234

Provider Enumeration Date	:	03/01/2018
Last Update Date	:	03/01/2018

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Directions to “ALLIED HEALTH PROFESSIONALS ” Practice Location

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