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General NPI Number Information
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NPI Number | 1194662999
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Entity Type | Individual
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Provider Name | JESSICA REASONONVER HOLLER LADC II
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Gender | Female
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 5511 VIRGINIA WAY STE 300
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City | BRENTWOOD
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State | TN
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Zip | 37027-7611
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Country | US
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Telephone | 615-994-1000
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Fax | 615-994-0100
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Provider Business Mailing Address
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Address Line | 4959 SULPHUR CREEK RD
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City | NASHVILLE
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State | TN
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Zip | 37218-3516
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Country | US
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Telephone | 629-333-9081
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1855
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License Number State | TN
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