Doctor Name: | JASON THOMAS LINK |
NPI Number: | 1164447223 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 1496 |
Business Practice Address: | 21 Cooks Rd Mt Juliet, TN - 371226824 |
Business Phone Number: | 6154535318 |
Business Fax Number: | 6154535318 |
Mailing Address: | 21 Cooks Rd, MT JULIET |
State: | TN |
Postal Code: | 371226824 |
Phone Number: | 6154535318 |
Fax Number: | 6154535318 |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1496 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |