Individual
OTIS SUMLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1355 LYNNFIELD RD, SUITE 245, MEMPHIS, TN 38119-5801
(901) 818-5433
Mailing address
1355 LYNNFIELD RD, SUITE 245, MEMPHIS, TN 38119-5801
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW3241
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
342576
MANAGED HEALTH N/W
—
01
—
4080319
B/C
TN
Enumeration date
08/31/2006
Last updated
07/08/2007
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