Individual
JERALD TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
1005 9TH AVE S, NASHVILLE, TN 37203-4729
(615) 636-1637
Mailing address
1005 9TH AVE S, NASHVILLE, TN 37203-4729
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4947
TN
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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