Individual
ILLISA LEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3400 LEBANON RD, MURFREESBORO, TN 37129-1392
(615) 946-6985
Mailing address
588 NEAL RD, WATERTOWN, TN 37184-3609
(615) 946-6985
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13852
TN
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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