Individual
KELLEY M BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
795 HOLLY LN, WAVERLY, TN 37185
(931) 296-9813
(931) 296-9853
Mailing address
795 HOLLY LN, WAVERLY, TN 37185-3392
(931) 296-9813
(931) 296-9853
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
567
TN
Other
Enumeration date
12/08/2006
Last updated
06/10/2019
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