Individual
MRS. MARILYN DERDEN PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
928 N JACKSON ST, TULLAHOMA, TN 37388-2332
(931) 454-2242
(931) 454-1217
Mailing address
353 MOTLOW RD, TULLAHOMA, TN 37388-7804
(615) 390-1153
(931) 454-1217
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000004233
TN
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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