| Doctor Name: | MRS. IDA SUELLEN WESTERMAN |
| NPI Number: | 1063509578 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | EDS LICENSED PROFESS |
| License Number: | 0000000068 |
| Business Practice Address: | 205 B East Main Street Waverly, TN - 37185 |
| Business Phone Number: | 9312091249 |
| Business Fax Number: | 9312962397 |
| Mailing Address: | 659 Tucker Rd, DICKSON |
| State: | TN |
| Postal Code: | 370555623 |
| Phone Number: | 9312091249 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0000000068 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |