Individual
MS. JENNIFER LEA GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-MHSP
Contact information
Practice address
204 ROGOSIN DR STE 4, ELIZABETHTON, TN 37643-2965
(423) 542-9900
(423) 543-0900
Mailing address
204 ROGOSIN DR STE 4, ELIZABETHTON, TN 37643-2965
(423) 542-9900
(423) 543-0900
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC0000002421
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517520
—
TN
Enumeration date
10/24/2006
Last updated
03/26/2013
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