Individual
MICHELLE FAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2700 EXECUTIVE PARK NW STE A, CLEVELAND, TN 37312-2770
(423) 436-1565
(423) 558-3458
Mailing address
2700 EXECUTIVE PARK NW STE A, CLEVELAND, TN 37312-2770
(423) 436-1565
(423) 558-3458
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3846
TN
103TS0200X
School Psychologist
593740
TN
Other
Enumeration date
12/02/2013
Last updated
01/09/2026
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