Most Relevant Information
Provider Data
| NPI Number: | 1003528878 |
| Provider Name: | GWEN AILEEN PONTIKES |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/23/2022 |
| Last Updated: | 12/23/2022 |
Provider Practice Location
8283 RIVER ROAD PIKE
NASHVILLE
TN
372096009
Practice Location Phone/Fax
| Phone: | 6153562700 |
| Fax: |
Provider Mailing Location
2206 BELMONT BLVD
NASHVILLE
TN
372125106
Provider Mailing Phone/Fax
| Phone: | 7739889220 |
| Fax: |