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1003321902
GLEN GAUGH
JACKSON, TN
NPI
1003321902
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: TN 9206)
Enumeration Date
2017-12-13
Last Update Date
2017-12-13
Business Address
GLEN GAUGH LMSW
24 WEATHERFORD SQ
JACKSON, TN 38305-2202
Phone number: 731-660-6730
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Mailing Address
GLEN GAUGH LMSW
24 WEATHERFORD SQ
JACKSON, TN 38305-2202
Phone number: 731-660-6730
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