Provider Demographics
NPI:1407026453
Name:AIMEE MILTICH LYST, PHD, PLLC
Entity Type:Organization
Organization Name:AIMEE MILTICH LYST, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:MILTICH
Authorized Official - Last Name:LYST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:615-790-3200
Mailing Address - Street 1:570 BAKERS BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6456
Mailing Address - Country:US
Mailing Address - Phone:615-790-3200
Mailing Address - Fax:615-794-2883
Practice Address - Street 1:570 BAKERS BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6456
Practice Address - Country:US
Practice Address - Phone:615-790-3200
Practice Address - Fax:615-794-2883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2760103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty