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General NPI Number Information
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NPI Number | 1699757013
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Entity Type | Individual
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Provider Name | ELDORA L FITZSIMMONS L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 11/20/2005
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 1031 ELEANOR ST
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City | KNOXVILLE
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State | TN
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Zip | 37917-6641
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Country | US
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Telephone | 865-607-1031
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Fax | 865-523-4818
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Provider Business Mailing Address
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Address Line | PO BOX 27183
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City | KNOXVILLE
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State | TN
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Zip | 37927-7183
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Country | US
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Telephone | 865-523-4818
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Fax | 865-774-4235
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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 | 00003384
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License Number State | TN
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