Individual provider · Type 1 NPI
Liane Videres De Souza, LPC
Professional Counselor · Collegedale, TN
NPI number
1619014768
Active
Practice location
4881 Taylor Circle
Collegedale, TN 37315
Fax (423) 263-1782
Mailing address
PO Box 775
Collegedale, TN 37315-0775
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC1630 (TN) |
Professional Counselor: Definition to come...
About NPI 1619014768
Liane Videres De Souza, LPC's National Provider Identifier is 1619014768, issued on Jan 30, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Collegedale, TN. The record was last updated on Jul 8, 2007.