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Organization
THE PRACTICAL CLINICIAN PLLC
Active
Organization
THE PRACTICAL CLINICIAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY RENEE WILSON-LEWIS PH.D.. , CCC-SLP (CLINICAL OWNER)
(678) 667-4650
Entity
Organization
Contact information
Practice address
462 BRECKENRIDGE TRCE, KINGSPORT, TN 37663-2988
(678) 667-4650
Mailing address
462 BRECKENRIDGE TRCE, KINGSPORT, TN 37663-2988
(678) 667-4650
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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