Individual
MR. SIMON ALAN RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
901 E SUMMIT HILL DR, KNOXVILLE, TN 37915-1200
(865) 524-7483
Mailing address
5907 VAN HORN RD, KNOXVILLE, TN 37918-3831
(865) 688-4609
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3075
TN
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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