Individual
JELISA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-MHSP
Contact information
Practice address
3085 FOUNTAINSIDE DR STE 110, GERMANTOWN, TN 38138-7840
(901) 238-8926
Mailing address
2657 CROSSVINE CV S, CORDOVA, TN 38016-8460
(901) 238-8926
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3760
TN
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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