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Individual

KALLAN PARKER LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
168 W UNIVERSITY PKWY, JACKSON, TN 38305-1624
(731) 300-2619
Mailing address
168 W UNIVERSITY PKWY STE C, JACKSON, TN 38305-1624

Taxonomy

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

Other

Enumeration date
07/17/2022
Last updated
07/17/2022
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