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General NPI Number Information
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NPI Number | 1457720906
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Entity Type | Individual
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Provider Name | REBECCA J JASINSKI I M.A.,
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Gender | Female
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 509 N CEDAR AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-1707
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Country | US
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Telephone | 931-520-8435
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Fax | 931-372-7225
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Provider Business Mailing Address
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Address Line | 509 N CEDAR AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-1707
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Country | US
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Telephone | 931-520-8435
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Fax | 931-372-7225
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | TN
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