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NPI Code Detail

MEDICARE: JESSICA WEBSTER

MEDICARE:   JESSICA  WEBSTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor5730TN

General Provider Information

NPI Number : 1093446882
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA WEBSTER
Provider Business Mailing Address
First Line : 3676 STONETRACE CIR
Second Line :
City : BARTLETT
State : TN
Zip : 38135-3089
Country : US
Telephone Number : 901-484-3738
Fax Number :
Provider Business Practice Location Address
First Line : 152 TIMBER CREEK DR STE 4
Second Line :
City : CORDOVA
State : TN
Zip : 38018-4237
Country : US
Telephone Number : 901-498-9126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2022
Last Update Date : 06/22/2022

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Directions to “ JESSICA WEBSTER ” Practice Location

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