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Individual

DONNA JO MAHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC, CADC

Contact information

Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8727
(606) 523-8779
Mailing address
PO BOX 1325, CORBIN, KY 40702-1325
(606) 526-8131
(606) 528-8661

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YP2500X
Professional Counselor
Primary
0626
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100282390
KY
Enumeration date
08/15/2013
Last updated
03/11/2015
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