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Individual

MRS. BRENDA JOYCE SOUTHERLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3508 MARYVILLE PIKE, SUITE E, KNOXVILLE, TN 37920-6195
(865) 579-5886
(865) 579-5884
Mailing address
3508 MARYVILLE PIKE, SUITE E, KNOXVILLE, TN 37920-6195
(865) 579-5886
(865) 579-5884

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3535
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3132589
BCBS
TN
05
3920199
TN
Enumeration date
07/14/2006
Last updated
07/08/2007
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