Individual
KIANA SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
317 18TH AVE N STE 200, NASHVILLE, TN 37203-2253
(615) 292-3661
(615) 292-3662
Mailing address
317 18TH AVE N STE 200, NASHVILLE, TN 37203-2253
(615) 292-3661
(615) 292-3662
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X088312022
DRIVERS LICENSE
MO
Enumeration date
08/09/2022
Last updated
08/09/2022
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