Individual
KATHLEEN MARIE CUSTARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2305 N GATEWAY AVE UNIT 2, HARRIMAN, TN 37748-8709
(423) 240-4144
(865) 882-0099
Mailing address
2305 N GATEWAY AVE UNIT 2, HARRIMAN, TN 37748-8709
(423) 240-4144
(865) 882-0099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000008600
TN
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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