Individual
TIERRA THAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
925 E MAIN ST, HENDERSON, TN 38340-1709
(731) 989-3401
(731) 989-3838
Mailing address
925 E MAIN ST, HENDERSON, TN 38340-1709
(731) 989-3401
(731) 989-3838
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/19/2007
Last updated
10/19/2007
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