Individual
CHARLES BERNARD SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
1 LIFEWAY PLZ, NASHVILLE, TN 37234-0166
(615) 251-2953
(615) 251-5618
Mailing address
219 WINBURN LN, FRANKLIN, TN 37069-4103
(615) 595-0513
(615) 251-5618
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
TNLMT#221
TN
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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