Individual
CHASSIDY ISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPP
Contact information
Practice address
767 MAIN ST, WEST LIBERTY, KY 41472-1019
(606) 329-8588
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
UNLICENSED
—
103T00000X
Psychologist
PSYPAS00220824
KY
103TC0700X
Clinical Psychologist
Primary
264783
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30610026
—
KY
Enumeration date
06/18/2014
Last updated
08/01/2024
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