Individual
EMMA EIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 ARTHUR ST, KNOXVILLE, TN 37921-6405
(865) 532-8695
Mailing address
200 TECH CENTER DR, KNOXVILLE, TN 37912-2747
(865) 637-9711
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9220
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120667688
DRIVERS LICENSE
TN
01
—
9220
LICENSED CLINICAL SOCIAL WORKER
TN
Enumeration date
01/18/2022
Last updated
08/29/2024
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