Individual
REBECCA LEIGH WALDENSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
2001 STONEBROOK PL, KINGSPORT, TN 37660-4000
(423) 224-1000
(423) 224-1023
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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