Individual
MANDY COLBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC II
Contact information
Practice address
302 KELSAY DR, KINGSTON, TN 37763-3004
(865) 206-6971
Mailing address
302 KELSAY DR, KINGSTON, TN 37763-3004
(865) 206-6971
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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