Individual
MARK ALLEN JACOCKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7209 HAMILTON ACRES CIR, CHATTANOOGA, TN 37421-8623
(423) 499-9335
(423) 499-9334
Mailing address
7209 HAMILTON ACRES CIR, CHATTANOOGA, TN 37421-8623
(423) 499-9335
(423) 499-9334
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4879
TN
101YM0800X
Mental Health Counselor
Primary
4879
TN
101YP2500X
Professional Counselor
4879
TN
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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