Individual
DR. TERESA M KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
401 HOLSTON DRIVE, GREENEVILLE, TN 37743
(423) 639-7019
(423) 636-8365
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P778
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3090004
MAGELLAN NAVIGATOR
—
01
—
334969
VALUEOPTIONS GROUP
—
Enumeration date
08/13/2006
Last updated
07/08/2007
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