Individual
MS. KIMBERLY DAWN BUSHORE-MAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, MHSP
Contact information
Practice address
600 E UNAKA AVE, JOHNSON CITY, TN 37601-4035
(423) 202-4472
Mailing address
600 E UNAKA AVE, JOHNSON CITY, TN 37601-4035
(423) 202-4472
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2195
TN
Other
Enumeration date
07/31/2009
Last updated
07/31/2009
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