Individual
DIANE G JEFFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
925 E MAIN ST, HENDERSON, TN 38340-1709
(731) 989-3401
(731) 989-3838
Mailing address
16 CARTHAGE RD, JACKSON, TN 38305-9438
(731) 989-3401
(731) 989-3838
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LPC 328
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3156416
BCBS PROVIDER NUMBER
TN
Enumeration date
08/31/2006
Last updated
07/09/2007
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