Individual
MRS. HOLLY ANN JACKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
28 BRUMMEL LN, CROSSVILLE, TN 38558-2630
(615) 609-6361
(866) 341-7509
Mailing address
28 BRUMMEL LN, CROSSVILLE, TN 38558-2630
(615) 609-6361
(866) 341-7509
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000003184
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q000600
—
TN
Enumeration date
07/18/2011
Last updated
09/19/2022
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