Doctor Name: | MRS. THELMA WILLENE DEES-JOHNSON |
NPI Number: | 1194900373 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC-MHSP |
License Number: | 2111 |
Business Practice Address: | 307 Tyne Blvd Old Hickory, TN - 371381224 |
Business Phone Number: | 6158380241 |
Business Fax Number: | 6157541845 |
Mailing Address: | 307 Tyne Blvd, Po Box 132 OLD HICKORY |
State: | TN |
Postal Code: | 371381224 |
Phone Number: | 6158380241 |
Fax Number: | 6157541845 |
NPI Enumeration Date: | 01/07/2008 |
NPI Last Update Date: | 03/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2111 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |