Individual
LAURA JO VACHERESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4798 NEW HIGHWAY 68, MADISONVILLE, TN 37354
(423) 442-2622
Mailing address
PO BOX 278, MADISONVILLE, TN 37354-0278
(423) 442-2622
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0000006584
TN
1041S0200X
School Social Worker
000623914
TN
Other
Enumeration date
01/27/2015
Last updated
10/11/2018
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