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General NPI Number Information
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NPI Number | 1821110149
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Entity Type | Individual
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Provider Name | BRENDA SUE KEITH CMSW
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 633 THOMPSON LN
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City | NASHVILLE
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State | TN
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Zip | 37204-3616
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Country | US
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Telephone | 615-460-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 BRET RIDGE DR
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City | HERMITAGE
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State | TN
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Zip | 37076-4314
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Country | US
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Telephone | 615-305-9754
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | CSW0000006007
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License Number State | TN
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