Individual
JESSICA MAHANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1830 DESTINY LN STE 112, BOWLING GREEN, KY 42104-1089
(270) 792-0400
Mailing address
755 LEAYOU RD, ALVATON, KY 42122-9634
(270) 792-0400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254321
KY
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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