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NPI 1447062526

NPI 1447062526 : LISA MARIE KELCHNER : WHITE HOUSE, TN

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General NPI Number Information
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    NPI Number           |    1447062526
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    Entity Type          |    Individual 
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    Provider Name        |    LISA MARIE KELCHNER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/24/2025
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    Last Update Date     |    01/24/2025
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Provider Practice Location Address
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    Address Line         |    3326 HWY 31W 
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    City                 |    WHITE HOUSE
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    State                |    TN
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    Zip                  |    37188-8973
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    Country              |    US
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    Telephone            |    615-957-7354
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    185B SHUN PIKE 
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    City                 |    COTTONTOWN
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    State                |    TN
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    Zip                  |    37048-5010
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    Country              |    US
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    Telephone            |    615-957-7354
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    
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    License Number State |    
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