Individual
MR. JACK L JUSTIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1233 17TH AVE S, NASHVILLE, TN 37212-2801
(615) 329-4182
(615) 327-9399
Mailing address
PO BOX 682184, FRANKLIN, TN 37068-2184
(615) 329-4182
(615) 327-9399
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MFT
TN
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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