Organization
BLUE RIDER EXPRESSIVE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JEAN WATTS (OWNER)
(517) 215-6766
Entity
Organization
Contact information
Practice address
2528 DWIGHT COCHRAN RD, DUCK RIVER, TN 38454-3434
(517) 215-6766
Mailing address
2528 DWIGHT COCHRAN RD, DUCK RIVER, TN 38454-3434
(517) 215-6766
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/09/2020
Last updated
02/06/2024
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