| Doctor Name: | DR. PRESTON VISSER |
| NPI Number: | 1710110747 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | 318 Donnelly St Mountain City, TN - 376831510 |
| Business Phone Number: | 4237272100 |
| Business Fax Number: | 4234673644 |
| Mailing Address: | 1167 Spratlin Park Dr, Pob 9054 GRAY |
| State: | TN |
| Postal Code: | 376156205 |
| Phone Number: | 4234673600 |
| Fax Number: | 4234673644 |
| NPI Enumeration Date: | 08/25/2009 |
| NPI Last Update Date: | 10/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |