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Individual

CAROLYN BEATY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1684 HUNTGATE CV, CORDOVA, TN 38016-1429
(901) 268-7484
Mailing address
1684 HUNTGATE CV, CORDOVA, TN 38016-1429
(901) 268-7484

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
88-4058603
TN
Enumeration date
11/25/2022
Last updated
11/25/2022
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