Individual
ANGELA D OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8019 VINEYARD LN, LA VERGNE, TN 37086-5110
(615) 939-3391
Mailing address
8019 VINEYARD LN, LA VERGNE, TN 37086-5110
(615) 939-3391
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14501
TN
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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