Provider Demographics
NPI:1972197333
Name:CENTER, RALINE (MA EDS)
Entity Type:Individual
Prefix:
First Name:RALINE
Middle Name:
Last Name:CENTER
Suffix:
Gender:F
Credentials:MA EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 SPLIT RAIL DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5737
Mailing Address - Country:US
Mailing Address - Phone:615-828-6896
Mailing Address - Fax:
Practice Address - Street 1:616 SPLIT RAIL DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5737
Practice Address - Country:US
Practice Address - Phone:615-828-6896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1380101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health