Individual
JELESSA LASHAE CROSBY-POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 TYNEWOOD DR, CLARKSVILLE, TN 37042-5284
(618) 501-7109
Mailing address
2010 TYNEWOOD DR, CLARKSVILLE, TN 37042-5284
(618) 501-7109
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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