Provider Demographics
NPI:1508532839
Name:MUGLESTON, JENNIFER (MASTER OF ARTS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MUGLESTON
Suffix:
Gender:F
Credentials:MASTER OF ARTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 MIDDLEBROOK PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-6503
Mailing Address - Country:US
Mailing Address - Phone:865-444-2333
Mailing Address - Fax:
Practice Address - Street 1:3712 MIDDLEBROOK PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-6503
Practice Address - Country:US
Practice Address - Phone:865-444-2333
Practice Address - Fax:615-292-3662
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health