Provider Demographics
NPI:1215380233
Name:HERMANSON, KALEE
Entity Type:Individual
Prefix:
First Name:KALEE
Middle Name:
Last Name:HERMANSON
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 1:1202 S JAMES CAMPBELL BLVD
Mailing Address - Street 2:SUITE 7A
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-5193
Mailing Address - Country:US
Mailing Address - Phone:931-381-0020
Mailing Address - Fax:931-381-0529
Practice Address - Street 1:1202 S JAMES CAMPBELL BLVD
Practice Address - Street 2:SUITE 7A
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-5193
Practice Address - Country:US
Practice Address - Phone:931-381-0020
Practice Address - Fax:931-381-0529
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)