Vanderbilt, Kenwana Michelle

Vanderbilt, Kenwana Michelle is an individual health care provider with primary practice located at Macon Outpatient Clinic- 5398 Thomaston Rd. Suite B, Macon GA 31220. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Vanderbilt, Kenwana Michelle can be contacted via phone (478) 476-8868.

Contact Information

Primary practice address
Macon Outpatient Clinic- 5398 Thomaston Rd. Suite B Macon GA 31220
Fax: (478) 476-8161
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY003494 Georgia

Profile Details

NPI number 1174864979
LBN Legal business name Vanderbilt, Kenwana Michelle
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2013
Last updated Mar 9th, 2016 - about 8 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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