Individual
MARISHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1261 KENMORE PL, NASHVILLE, TN 37216-3214
(615) 801-3495
Mailing address
1261 KENMORE PL, NASHVILLE, TN 37216-3214
(615) 801-3495
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
TN
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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