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Individual

LASTACIA PEELE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
118 UNION ST, CLARKSVILLE, TN 37040-5115
(931) 647-8257
(931) 647-8257
Mailing address
410 AMBROSE DR, CLARKSVILLE, TN 37042-5101
(931) 378-1868

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
04/15/2014
Last updated
04/15/2014
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