Doctor Name: | DR. GARY B VERNA |
NPI Number: | 1619954781 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | P0000001449 |
Business Practice Address: | 300 W Beech St Rm 1 La Follette, TN - 377663516 |
Business Phone Number: | 8657120234 |
Business Fax Number: | 4235626106 |
Mailing Address: | Po Box 4818, OAK RIDGE |
State: | TN |
Postal Code: | 378314818 |
Phone Number: | 8657120234 |
Fax Number: | 4235626106 |
NPI Enumeration Date: | 12/29/2005 |
NPI Last Update Date: | 12/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | P0000001449 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |