Individual
MS. KELLY L DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
294 GAMBLE ST, MARYVILLE, TN 37801
(865) 681-3726
(865) 982-8198
Mailing address
PO BOX 4982, 294 GAMBLE ST, MARYVILLE, TN 37802-4982
(865) 681-3726
(865) 982-8198
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1240
TN
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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