Individual
LISA WILMOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1200 S WILLOW AVE, COOKEVILLE, TN 38506-4157
(931) 432-4123
Mailing address
201 W SPRINGDALE AVE, KNOXVILLE, TN 37917-5158
(865) 637-6711
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/18/2014
Last updated
01/14/2020
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