Individual
CALEB KENNETH VIVIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
109 TUCKER ST, JACKSON, TN 38301-4092
(731) 203-1584
(574) 635-9228
Mailing address
7556 US HIGHWAY 70, BARTLETT, TN 38133-2686
(901) 552-3497
(574) 635-9228
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5554
TN
Other
Enumeration date
02/12/2024
Last updated
08/15/2024
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