Individual
KELLY J MEDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2001 E STONEBROOK PL, KINGSPORT, TN 37660-4000
(423) 224-1000
(423) 467-3644
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4584
TN
Other
Enumeration date
10/11/2019
Last updated
10/11/2019
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