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1649594029
JACKIE TANNA
CLARKSDALE, MS
NPI
1649594029
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2010-03-15
Last Update Date
2010-03-15
Business Address
JACKIE TANNA MA
1742 CHERYL ST
CLARKSDALE, MS 38614-7218
Phone number: 662-627-7267
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Mailing Address
JACKIE TANNA MA
PO BOX 1046
CLARKSDALE, MS 38614-1046
Phone number: 662-627-7267
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