Provider Demographics
NPI:1467201970
Name:PATE, DAVID (MRE)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PATE
Suffix:
Gender:M
Credentials:MRE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2377
Mailing Address - Country:US
Mailing Address - Phone:931-723-0380
Mailing Address - Fax:
Practice Address - Street 1:806 CLOVER LN
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2377
Practice Address - Country:US
Practice Address - Phone:931-723-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral