Healthcare Provider Details

I. General information

NPI: 1922926294
Provider Name (Legal Business Name): JODEE C LAVOIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 LEATHERWOOD CREEK RD N
PULASKI TN
38478-7261
US

IV. Provider business mailing address

808 LEATHERWOOD CREEK RD N
PULASKI TN
38478-7261
US

V. Phone/Fax

Practice location:
  • Phone: 931-292-9488
  • Fax:
Mailing address:
  • Phone: 931-292-9488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: