Individual
WALLY W JURASCHKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5575 POPLAR AVE STE 320, MEMPHIS, TN 38119-3862
(901) 763-0909
(901) 763-4060
Mailing address
2440 FAIRWAY OAKS DR, MEMPHIS, TN 38134-5587
(901) 647-7822
(901) 763-4060
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMT 104 PE 151
TN
Other
Enumeration date
04/08/2007
Last updated
07/08/2007
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