Individual
JANIE ALLENE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
306 W HOLSTON AVE, JOHNSON CITY, TN 37604-5526
(423) 930-4986
Mailing address
306 W HOLSTON AVE, JOHNSON CITY, TN 37604-5526
(423) 930-4986
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5253
TN
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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