Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 5801 | TN |
NPI | 1003072737 |
---|---|
Provider Name | Joseph John Kochelek |
First Address | Nashville, TN 37228-1805 |
Second Address | Nashville, TN 37228-1805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2008 |
Last Update Date | 31/05/2019 |