Provider Demographics
NPI:1629804596
Name:PRITCHETT, KIMBERLY RENAE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RENAE
Last Name:PRITCHETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 MANSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2710
Mailing Address - Country:US
Mailing Address - Phone:615-788-5072
Mailing Address - Fax:
Practice Address - Street 1:5300 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1715
Practice Address - Country:US
Practice Address - Phone:615-882-4196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health