Individual
JO ELLYN WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8372
(270) 956-0180
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8372
(270) 956-0180
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2396
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VAD000
FEDERAL HOSPITAL
—
Enumeration date
11/03/2009
Last updated
11/03/2009
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