Individual
MATTIE C CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CM
Contact information
Practice address
238 SUMMAR DR, JACKSON, TN 38301-3906
(731) 512-0104
(731) 512-0601
Mailing address
238 SUMMAR DR, JACKSON, TN 38301-3906
(731) 512-0104
(731) 512-0601
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/15/2011
Last updated
12/15/2011
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