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NPI Code Detail

MEDICARE: JESSICA LYNNE SOETERS

MEDICARE:   JESSICA LYNNE SOETERS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1194436949
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LYNNE SOETERS
Provider Business Mailing Address
First Line : 5025 HILLSBORO PIKE APT 23E
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-3726
Country : US
Telephone Number : 616-848-0889
Fax Number :
Provider Business Practice Location Address
First Line : 5025 HILLSBORO PIKE APT 23E
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-3726
Country : US
Telephone Number : 616-848-0889
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2022
Last Update Date : 12/12/2022

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Directions to “ JESSICA LYNNE SOETERS ” Practice Location

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