Individual
VIVIAN L. MINTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C., M.H.S.P.
Contact information
Practice address
620 OLD HICKORY BLVD STE 204, JACKSON, TN 38305-2904
(731) 217-0949
Mailing address
620 OLD HICKORY BLVD STE 204, JACKSON, TN 38305-2904
(731) 217-0949
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC0000001857
TN
101YP2500X
Professional Counselor
Primary
LPC0000001857
TN
Other
Enumeration date
05/22/2008
Last updated
02/05/2022
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