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General NPI Number Information
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NPI Number | 1508688045
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Entity Type | Individual
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Provider Name | MS. LU FANG
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 112 S MAPLE ST STE C-3
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City | MURFREESBORO
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State | TN
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Zip | 37130-3530
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Country | US
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Telephone | 629-251-7588
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Fax |
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Provider Business Mailing Address
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Address Line | 4957 SAINT IVES DR
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City | MURFREESBORO
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State | TN
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Zip | 37128-2767
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Country | US
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Telephone | 629-251-7588
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 000734574
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6989
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License Number State | TN
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