Individual
MRS. KATHARINE KELLIE MEDICUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
428 E SCOTT AVE, SUITE 106, KNOXVILLE, TN 37917-6362
(865) 621-7644
(865) 329-9433
Mailing address
234 E OKLAHOMA AVE, KNOXVILLE, TN 37917-6332
(865) 637-6793
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4561
TN
Other
Enumeration date
10/15/2007
Last updated
11/17/2008
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