Most Relevant Information
Provider Data
| NPI Number: | 1003406695 |
| Provider Name: | KRYSTEN KELCH LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 7543 |
Most Important Dates
| Enumeration Date: | 01/19/2021 |
| Last Updated: | 01/19/2021 |
Provider Practice Location
112 E MYRTLE AVE STE 300
JOHNSON CITY
TN
376014644
Practice Location Phone/Fax
| Phone: | 4234610015 |
| Fax: |
Provider Mailing Location
112 E MYRTLE AVE STE 300
JOHNSON CITY
TN
376014644
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |