Individual
MADISON ELAINE IDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
185 SERRAL DR, GREENEVILLE, TN 37745-3067
(423) 609-3312
Mailing address
390 OLD ERWIN HWY, GREENEVILLE, TN 37745-3785
(423) 773-2360
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8752
TN
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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