Individual
MRS. VICKIE M DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5833 CLINTON HWY, KNOXVILLE, TN 37912-2556
(865) 603-3260
Mailing address
3223 JOHNSTON ST, KNOXVILLE, TN 37921-1910
(865) 603-3260
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
5409
TN
1041C0700X
Clinical Social Worker
Primary
CSW0000005687
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q044310
—
TN
Enumeration date
02/01/2007
Last updated
03/01/2019
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