# MOBILE PSYCHOLOGY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669724357
- **Authorized official:** DR. RITA MARIE JUNGBLOM PSY.D. (OWNER)
- **Authorized official phone:** (270) 875-2544

## Contact information

- **Practice address:** 345 LEROY ROAD, HANSON, KY 42413-9657
- **Practice address phone:** (270) 875-2544
- **Practice address fax:** (270) 342-5411
- **Mailing address:** 345 LEROY ROAD, HANSON, KY 42413-9657
- **Mailing address phone:** (270) 875-2544
- **Mailing address fax:** (270) 342-5411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 1355 | KY | Yes |

## Other

- **Enumeration date:** 10/05/2012
- **Last updated:** 09/15/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100240540 | — | KY |
| 05 | — | 7100297310 | — | KY |