Individual
MISS KATISHA FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 CULLY RD, CORDOVA, TN 38018-8502
(901) 624-2454
Mailing address
1155 CULLY RD, CORDOVA, TN 38018-8502
(901) 870-2650
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
092234118
TN
Other
Enumeration date
09/27/2010
Last updated
09/27/2010
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