Individual
KISHA DARLENE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
108 S 1ST ST, UNION CITY, TN 38261-3802
(731) 335-6655
Mailing address
PO BOX 511, UNION CITY, TN 38281-0511
(731) 335-6655
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6948
TN
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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