Individual
ELICIA MARIE MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7556 US HIGHWAY 70, BARTLETT, TN 38133-2686
(901) 552-3497
(574) 635-9228
Mailing address
7556 US HIGHWAY 70, BARTLETT, TN 38133-2686
(901) 552-3497
(574) 635-9228
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/03/2020
Last updated
10/22/2021
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