Individual
MS. ANDREA MARIE SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
2960B OLD AUSTIN PEAY HWY, MEMPHIS, TN 38128-5631
(901) 372-7878
Mailing address
2960B OLD AUSTIN PEAY HWY, MEMPHIS, TN 38128-5631
(901) 372-7878
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BSW0000000658
TN
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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