Healthcare Provider Details

I. General information

NPI: 1619616430
Provider Name (Legal Business Name): CATHY ANN HUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 LETNER RD
HELENWOOD TN
37755-5196
US

IV. Provider business mailing address

681 LETNER RD
HELENWOOD TN
37755-5196
US

V. Phone/Fax

Practice location:
  • Phone: 423-215-4130
  • Fax:
Mailing address:
  • Phone: 423-215-4130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5724
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: