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General NPI Number Information
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NPI Number | 1447495544
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Entity Type | Individual
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Provider Name | NANCY GRAVES WAHLER LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | 5959 SHALLOWFORD RD STE 429-4
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2289
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Country | US
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Telephone | 865-405-9919
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Fax | 866-209-4029
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Provider Business Mailing Address
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Address Line | 5116 GRAYSTONE LN
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City | OOLTEWAH
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State | TN
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Zip | 37363-8646
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Country | US
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Telephone | 865-405-9919
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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 | LSW0000004128
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License Number State | TN
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