Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003164708 |
---|---|
Provider Name | Nevada J Jefferson |
First Address | Nashville, TN 37228-1604 |
Second Address | Nashville, TN 37228-1604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2012 |
Last Update Date | 02/07/2013 |