Individual
MRS. LIANE VIDERES DE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4881 TAYLOR CIRCLE, COLLEGEDALE, TN 37315
(423) 236-2081
(423) 263-1782
Mailing address
PO BOX 775, COLLEGEDALE, TN 37315-0775
(423) 236-2081
(423) 236-1782
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC1630
TN
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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