Individual
COLBIE STATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 E FRAZIER AVE, COLUMBIA, KY 42728-1915
(270) 384-4719
Mailing address
130 SOUTHERN SCHOOL RD, SOMERSET, KY 42501-3223
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1732
KY
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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