Individual
LISA C KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1997 HIGHWAY 51 S, COVINGTON, TN 38019-3630
(901) 476-8967
Mailing address
1997 HIGHWAY 51 S, COVINGTON, TN 38019-3630
(901) 476-8967
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0522
LAODAC LICENSE
TN
Enumeration date
04/02/2007
Last updated
03/28/2012
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