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Individual

KELLEY STREET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2400 WHITE AVE, NASHVILLE, TN 37204-2235
(615) 944-2668
Mailing address
2400 WHITE AVE, NASHVILLE, TN 37204-2235
(615) 944-2668

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YS0200X
School Counselor
000619471
TN

Other

Enumeration date
09/10/2015
Last updated
09/10/2015
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