Individual
KELLY MARIE BOURQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
108 4TH AVE S STE 205, FRANKLIN, TN 37064-2676
(615) 594-2830
Mailing address
109 LANES END DR, FRANKLIN, TN 37067-5101
(615) 594-2830
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
769
TN
Other
Enumeration date
07/20/2019
Last updated
07/20/2019
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