Provider Demographics
NPI:1831335512
Name:VALLI, JENNIFER LOU (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LOU
Last Name:VALLI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 CORDOVA CV
Mailing Address - Street 2:SUITE #1
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2211
Mailing Address - Country:US
Mailing Address - Phone:901-753-7700
Mailing Address - Fax:901-751-9977
Practice Address - Street 1:1384 CORDOVA CV
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2211
Practice Address - Country:US
Practice Address - Phone:901-299-3224
Practice Address - Fax:901-751-9977
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2009-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45131041C0700X
MD089441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical