Individual
MRS. PENNIE SMITH HEATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1840 AUTUMN AVE, MEMPHIS, TN 38112-5310
(901) 725-2724
(901) 725-2724
Mailing address
1840 AUTUMN AVE, MEMPHIS, TN 38112-5310
(901) 725-2724
(901) 725-2724
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0000003639
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3920071
—
TN
01
—
4173199
BCBS OF TENNESSEE
TN
01
—
P00456850
RAILROAD MEDICARE
—
Enumeration date
12/09/2007
Last updated
07/03/2008
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