Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 12112 | TN |
N | 104100000X | Social Worker | 33008716A | IN |
Y | 104100000X | Social Worker | LSW7740 | TN |
NPI | 1003307232 |
---|---|
Provider Name | Shelby Paige Buffin |
First Address | Morristown, TN 37813-5654 |
Second Address | Knoxville, TN 37921-5718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2018 |
Last Update Date | 04/08/2021 |