Autum Wade is a Peer Specialist based in Johnson City, TN. Autum Wade practices in Johnson City, TN. The NPI Number for Autum Wade is 1063155364 and holds a License No. 000-1410 (Tennessee).
The current practice location address for Autum Wade is 102 N Broadway St, Johnson City, TN and can be reached out via phone at 423-588-9988.
Location: 102 N Broadway St, Johnson City, TN, 37601-3525
Provider Profile Details
NPI Number
1063155364
Provider Name
Autum Wade
Credential
Provider Entity Type
Individual
Gender
Female
Address
102 N Broadway St, Johnson City, TN, 37601-3525
Phone Number
423-588-9988
Fax Number
Provider Enumeration Date
04/15/2022
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
102 N Broadway St
City
State
Zip
37601-3525
Phone Number
423-588-9988
Fax Number
Provider Business Mailing Address Details
Address
102 N Broadway St
City
State
Zip
37601-3525
Phone Number
423-588-9988
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
000-1410 (Tennessee)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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