Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003204496 |
---|---|
Provider Name | Travis Kobler |
First Address | Nashville, TN 37211-4143 |
Second Address | Knoxville, TN 37912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2015 |
Last Update Date | 07/01/2015 |