Provider Demographics
NPI:1932607124
Name:VANDERLAND, KRISTYN LEANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:LEANNE
Last Name:VANDERLAND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MASCOT
Mailing Address - State:TN
Mailing Address - Zip Code:37806-1411
Mailing Address - Country:US
Mailing Address - Phone:865-296-0331
Mailing Address - Fax:
Practice Address - Street 1:2922 GROVE RD
Practice Address - Street 2:
Practice Address - City:MASCOT
Practice Address - State:TN
Practice Address - Zip Code:37806-1411
Practice Address - Country:US
Practice Address - Phone:865-296-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist