Individual
JESSIE SIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 GARVIN PL, LOUISVILLE, KY 40203-3178
(502) 416-8783
Mailing address
11118 SANDWOOD PL, LOUISVILLE, KY 40272-5301
(502) 650-3928
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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