Individual
KYLIE DEANNA STOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC/MHSP
Contact information
Practice address
240 W TYRONE RD, OAK RIDGE, TN 37830-6517
(865) 481-6175
Mailing address
12501 CHOTO MILL LN, KNOXVILLE, TN 37922-0615
(865) 392-1600
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4660
TN
163WG0000X
General Practice Registered Nurse
228872
TN
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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