Individual
KIMBERLY JOANN FAUCETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
659 MORGANTON SQUARE DR, MARYVILLE, TN 37801-4763
(865) 293-9025
Mailing address
704 WOODCHASE DR, KNOXVILLE, TN 37934-1626
(865) 293-9025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW4143
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3927623
—
TN
Enumeration date
07/14/2005
Last updated
04/14/2011
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