Individual
JONATHAN TYLER ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
118 GRAND VUE PLZ, HAZARD, KY 41701-6842
(606) 487-1646
Mailing address
PO BOX 127, ISOM, KY 41824-0127
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
267974
KY
Other
Enumeration date
12/21/2021
Last updated
12/21/2021
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