Healthcare Provider Details

I. General information

NPI: 1699961961
Provider Name (Legal Business Name): MICHELLE SCHWARTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BRANDAU DR
KNOXVILLE TN
37920-5827
US

IV. Provider business mailing address

405 BRANDAU DRIVE
KNOXVILLE TN
37920-5158
US

V. Phone/Fax

Practice location:
  • Phone: 865-919-6593
  • Fax: 865-249-8458
Mailing address:
  • Phone: 865-919-6593
  • Fax: 865-249-8458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: