Learn Healing Brain Llc | |
4646 Poplar Ave Ste 409 Memphis TN 38117-4434 | |
(901) 582-7243 | |
(901) 425-9853 |
Full Name | Learn Healing Brain Llc |
---|---|
Speciality | Physician Assistant |
Location | 4646 Poplar Ave Ste 409, Memphis, Tennessee |
Authorized Official Name and Position | Lea Hayley Brainerd (CEO) |
Authorized Official Contact | 9016121486 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Learn Healing Brain Llc 1028 Cresthaven Rd Ste 200 Memphis TN 38119-3867 Ph: (901) 612-1486 | Learn Healing Brain Llc 4646 Poplar Ave Ste 409 Memphis TN 38117-4434 Ph: (901) 582-7243 |
NPI Number | 1770291189 |
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Provider Enumeration Date | 11/14/2022 |
Last Update Date | 09/18/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770291189 | NPI | - | NPPES |
TPPA490 | Other | FL | STATE LICENSE |
UC-51980AFD-1B01-483 | Other | PROFESSIONAL CERTIFIED COACH | |
4706 | Other | TN | LICENSE |
PA00599 | Other | MS | STATE LICENSE |
PA1099 | Other | WY | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
363A00000X | Physician Assistant | (* (Not Available)) | Primary |
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