Individual
MICHELE MATHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-MHSP
Contact information
Practice address
1511 N JACKSON ST, TULLAHOMA, TN 37388-2343
(931) 455-6213
(931) 455-6225
Mailing address
PO BOX 640, MCMINNVILLE, TN 37111-0640
(931) 815-1212
(931) 815-1221
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC0000002517
TN
101YM0800X
Mental Health Counselor
MH6857
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517981
—
TN
05
—
762549900
—
FL
Enumeration date
02/20/2008
Last updated
11/02/2010
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