Individual
STACI JENE' HARRUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 LILY CREEK RD STE 202, LOUISVILLE, KY 40243-2811
(502) 727-3647
Mailing address
800 LILY CREEK RD STE 202, LOUISVILLE, KY 40243-2811
(502) 727-3647
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
290514
KY
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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