Most Relevant Information
Provider Data
| NPI Number: | 1003233008 |
| Provider Name: | LEANNE BRADDOCK LMFT |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | 0645 |
Most Important Dates
| Enumeration Date: | 03/27/2014 |
| Last Updated: | 06/01/2016 |
Provider Practice Location
561 E MAIN ST
JACKSON
TN
383016451
Practice Location Phone/Fax
| Phone: | 9012190319 |
| Fax: | 9013779977 |
Provider Mailing Location
561 E MAIN ST
JACKSON
TN
383016451
Provider Mailing Phone/Fax
| Phone: | 9012190319 |
| Fax: | 9013779977 |