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Individual

JACOB DIDDENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
210 25TH AVE N STE 601, NASHVILLE, TN 37203-1631
(815) 541-1741
Mailing address
1803 BROADWAY APT 128, NASHVILLE, TN 37203-2778
(815) 541-1741

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LSW0000014921
TN

Other

Enumeration date
06/19/2024
Last updated
08/23/2024
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