Samantha Soares, CM
Counselor, Mental Health in Jackson, TN. Individual provider (NPI-1).
NPI number1821269986
StatusActive
Last updated in NPPESAug 17, 2009
Details
- NPI
- 1821269986
- Entity type
- Individual (NPI-1)
- Name
- Samantha Soares
- Credential
- CM
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 17, 2008
- Last updated
- Aug 17, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
1804 Highway 45 BypSuite 604
Jackson, TN 38305-4436
Phone 731-660-8759
Mailing address
238 Summar DrJackson, TN 38301-3906
Phone 731-660-8759
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