Individual
KATIE PATRICK CHRISTIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7075 GOLDEN OAKS LOOP W STE 8, SOUTHAVEN, MS 38671-9011
(901) 483-1086
Mailing address
7075 GOLDEN OAKS LOOP W STE 8, SOUTHAVEN, MS 38671-9011
(901) 483-1086
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
5994
TN
1041C0700X
Clinical Social Worker
Primary
C8518
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q006994
—
TN
Enumeration date
07/22/2014
Last updated
01/18/2022
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