Provider Information for 1649618521
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JESSICA SMITH HAMM LPC, MHSP
Other Names:Former Name:JESSICA LEE SMITH LPC,MHSPSex: Female
NPI: 1649618521
Last Updated: 2013-10-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1649618521 | ||||||||
| Enumeration Date | 2013-06-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1207 WASHINGTON ST W FAYETTEVILLE, TN 37334-2855 United States Phone: 615-504-1926 | Fax: | ||||||||
| Primary Practice Address | 709 DAVIDSON ST TULLAHOMA, TN 37388-3607 United States Phone: 615-504-1926 | Fax: | ||||||||
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