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Individual

AUDRA MARLANA TATE KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
701 CHEROKEE BLVD, CHATTANOOGA, TN 37405-3339
(423) 421-8733
Mailing address
PO BOX 493, WHITWELL, TN 37397-0493
(423) 421-8733

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2403
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1529812
TN
Enumeration date
02/20/2009
Last updated
04/10/2013
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