Individual
JALISSA FREDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9295 ACADIA PL, CORDOVA, TN 38018-7151
(423) 508-9964
Mailing address
9295 ACADIA PL, CORDOVA, TN 38018-7151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7408
TN
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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