Individual
TEBARGE LAKEISHA WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
C-11715
NM
1041C0700X
Clinical Social Worker
Primary
7813
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10137742
—
NM
Enumeration date
03/28/2018
Last updated
09/18/2023
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