Individual
JOSEPH WAYNE SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
207 ELK AVE S, FAYETTEVILLE, TN 37334-3051
(931) 993-0878
Mailing address
207 ELK AVE S, FAYETTEVILLE, TN 37334-3051
(931) 993-0878
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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