IDA MAE BOATMAN-GOUSSIOS

JEFFERSON CITY, TN
NPI1346405958
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: TN  2267)
Additional Taxonomies101YP2500X Counselor, Professional
(Licence: GA  LPC013160)
Enumeration Date2008-07-23
Last Update Date2025-01-02
Business Address
IDA MAE BOATMAN-GOUSSIOS LPC
1413 RUSSELL AVE
JEFFERSON CITY, TN 37760-2562
Phone number: 865-471-5525
Mailing Address
IDA MAE BOATMAN-GOUSSIOS LPC
PO BOX 577
NEWPORT, TN 37822-0577
Phone number: 423-613-3300