Individual
REISHA JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1037 CRESTHAVEN RD, MEMPHIS, TN 38119-3833
(901) 682-6136
(901) 682-7136
Mailing address
2231 OAK HOLLOW LN, CORDOVA, TN 38016-5206
(901) 239-4411
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4412
TN
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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