Judith R Roney, LMFT & LPC-MHSP

Individual provider Active NPI Marriage & Family Therapist · MC Minnville, TN

NPI 1104032283 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104032283
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
0000000030 (TN)
Practice address
743 Country Club Drive
MC Minnville, TN 37110-5011
Phone
(931) 668-9202
Fax
(931) 668-4410
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0000000030TNMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0000000030 TN Yes

Addresses

Primary practice location

743 Country Club Drive
MC Minnville, TN 37110-5011

Mailing address

743 Country Club Dr
MC Minnville, TN 37110-5011
Phone (931) 668-9202

Other providers in MC Minnville, TN

All providers in MC Minnville, TN · Marriage & Family Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.