Provider Demographics
NPI:1033414107
Name:GRABLE, THERESE ELIZABETH (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:ELIZABETH
Last Name:GRABLE
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:THERESE
Other - Middle Name:EIZABETH
Other - Last Name:TREJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-MHSP
Mailing Address - Street 1:5115 MARYLAND WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:615-500-4761
Mailing Address - Fax:
Practice Address - Street 1:5115 MARYLAND WAY
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7512
Practice Address - Country:US
Practice Address - Phone:615-500-4761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional