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General NPI Number Information
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NPI Number | 1740557883
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Entity Type | Individual
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Provider Name | TRISTA NICOLE ADAMS MS
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Gender | Female
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 60 LYNOAK CV SUITE C
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City | JACKSON
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State | TN
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Zip | 38305-2909
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Country | US
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Telephone | 731-668-7593
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Fax | 731-660-7512
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Provider Business Mailing Address
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Address Line | 2650 BOX ELDER DR
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City | ADAMSVILLE
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State | TN
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Zip | 38310-3414
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Country | US
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Telephone | 173-166-8759
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Fax | 173-166-0751
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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