Individual
MR. DEANGELO LACLARENCE JELKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3623 FOUNTAIN AVE, APARTMENT 73, EAST RIDGE, TN 37412-1846
(423) 954-8860
Mailing address
3623 FOUNTAIN AVE, APARTMENT 73, EAST RIDGE, TN 37412-1846
(423) 954-8860
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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