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Individual
JEROD MITCHELL THOMAS
Active
Individual
JEROD MITCHELL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
166725
KY
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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