Individual
SHANA INGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 BECKWITH RD, MOUNT JULIET, TN 37122-5104
(615) 582-4595
(615) 447-5981
Mailing address
1550 BECKWITH RD, MOUNT JULIET, TN 37122-5104
(615) 582-4595
(615) 447-5981
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
L000000017073
TN
Other
Enumeration date
11/16/2015
Last updated
11/16/2015
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