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General NPI Number Information
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NPI Number | 1306143508
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Entity Type | Individual
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Provider Name | MICHAEL V STANFIELD D.MIN., L.M.F.T.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 3700 KEOWEE AVE
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City | KNOXVILLE
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State | TN
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Zip | 37919-7711
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Country | US
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Telephone | 865-522-9804
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Fax | 865-523-9446
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Provider Business Mailing Address
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Address Line | 3700 KEOWEE AVE
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City | KNOXVILLE
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State | TN
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Zip | 37919-7711
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Country | US
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Telephone | 865-522-9804
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Fax | 865-523-9446
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMT0000000338
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License Number State | TN
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