Redwine, Angela M

Redwine, Angela M is an individual health care provider with primary practice located at 1511 N Jackson St , Tullahoma TN 37388-2343. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Redwine, Angela M can be contacted via phone (931) 455-6213.

Contact Information

Primary practice address
1511 N Jackson St Tullahoma TN 37388-2343
Phone: (931) 455-6213
Fax: (931) 455-6225
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X
Behavioral Health & Social Service Providers / Professional 101YP2500X 2784 Tennessee

Profile Details

NPI number 1639347636
LBN Legal business name Redwine, Angela M
Credentials PH.D., LPC-MHSP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2008
Last updated Apr 19th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639347636 NPPES
Tennessee Other 2784 LICENSE

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