Individual
MRS. KIMBERLY KEISLING GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5819 WINDING LN STE 105, HIXSON, TN 37343-4067
(423) 877-5042
Mailing address
5819 WINDING LN STE 105, HIXSON, TN 37343-4067
(423) 486-1266
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1712
TN
Other
Enumeration date
11/06/2019
Last updated
03/08/2021
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