Individual
ANGELA M REDWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LPC-MHSP
Contact information
Practice address
1511 N JACKSON ST, TULLAHOMA, TN 37388-2343
(931) 455-6213
(931) 455-6225
Mailing address
PO BOX 640, MCMINNVILLE, TN 37111-0640
(931) 507-1212
(931) 507-1217
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2784
TN
103TA0700X
Adult Development & Aging Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2784
LICENSE
TN
Enumeration date
02/13/2008
Last updated
04/19/2012
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