Individual
GLENDA F STOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
102 E RAVINE RD, KINGSPORT, TN 37660-3814
(423) 245-9600
(423) 245-9634
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 245-9600
(423) 245-9634
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
PO2636
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3983274
—
TN
Enumeration date
05/03/2006
Last updated
01/29/2024
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