Individual
TINA MARIE JONES-WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
411 BISHOP CT, MOREHEAD, KY 40351-1009
(606) 784-2096
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
103796
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30608012
—
KY
Enumeration date
09/04/2009
Last updated
02/06/2018
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