Individual
KRISTINA GILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
809 LAMONT STREET, MOUNTAIN HOME, TN 37684
(423) 926-1171
Mailing address
1185 W MTN VIEW RD, APT 1128, JOHNSON CITY, TN 37604-2523
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9809
TN
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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