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General NPI Number Information
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NPI Number | 1720699200
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Entity Type | Individual
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Provider Name | MISS KENDAL EMILYN GREINER
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Gender | Female
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 4160 OCOEE ST N STE 8
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City | CLEVELAND
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State | TN
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Zip | 37312-4886
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Country | US
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Telephone | 423-464-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 4875 PRESERVE DR
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City | CHATTANOOGA
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State | TN
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Zip | 37416-6115
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Country | US
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Telephone | 706-825-3290
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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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