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General NPI Number Information
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NPI Number | 1336797869
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Entity Type | Individual
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Provider Name | KELLY THERESA ARENA
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 2021 21ST AVE S STE C400
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City | NASHVILLE
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State | TN
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Zip | 37212-4350
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Country | US
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Telephone | 978-867-0431
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Fax |
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Provider Business Mailing Address
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Address Line | 21600 OXNARD ST STE 1800
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-7807
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Country | US
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Telephone | 818-345-2345
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1120503
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License Number State | MA
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