Individual
MARDREY ALICIA WADE KILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5104 STAGE RD, MEMPHIS, TN 38134-3164
(901) 646-1053
(901) 424-9078
Mailing address
1788 CHESHUNT LN, CORDOVA, TN 38016-3507
(901) 870-8682
(901) 424-9078
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4255
TN
Other
Enumeration date
05/03/2018
Last updated
08/26/2024
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