Individual
REBECCA MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
501 ADESA BLVD, SUITE A-150, LENOIR CITY, TN 37771-6725
(865) 986-8082
(865) 986-5890
Mailing address
6350 W ANDREW JOHNSON HWY, DEPARTMENT 100, TALBOTT, TN 37877-8605
(800) 355-3565
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10592 (LMSW)
TN
1041C0700X
Clinical Social Worker
Primary
LSW6990
TN
Other
Enumeration date
09/09/2016
Last updated
06/10/2019
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