Individual
STEPHANIE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMSW
Contact information
Practice address
6854 KERRY VALLEY LN, CORDOVA, TN 38018-2849
(901) 213-2993
Mailing address
6854 KERRY VALLEY LN, CORDOVA, TN 38018-2849
(901) 213-2993
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CSW0000005766
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW0000005766
STATE LIC
TN
Enumeration date
07/18/2006
Last updated
07/08/2007
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