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Individual

MRS. KAROLE DENISE BLAKE-SHORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2600 POPLAR AVE, SUITE 324, MEMPHIS, TN 38112-3851
(901) 324-0686
(901) 324-0688
Mailing address
2600 POPLAR AVE, SUITE 324, MEMPHIS, TN 38112-3851
(901) 324-0686
(901) 324-0688

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4250
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3699154
TN
Enumeration date
07/26/2006
Last updated
07/08/2007
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