Individual
JAN BOSTON SELLERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC,
Contact information
Practice address
261 YVONNE AVE, CROSSVILLE, TN 38555-4735
(931) 456-2859
(931) 797-8921
Mailing address
PO BOX 926, 261 YVONNE AVENUE, CROSSVILLE, TN 38557-0926
(931) 456-2859
(931) 797-8921
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0000002383
TN
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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