Individual
JENNIFER LYNN KOMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAMFT
Contact information
Practice address
8009 NEW LA GRANGE RD STE 1, LOUISVILLE, KY 40222-4791
(502) 396-0974
Mailing address
13609 TERRACE CREEK DR APT 300, LOUISVILLE, KY 40245-5832
(502) 396-0974
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
261334
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261334
MARRIAGE AND FAMILY THERAPY ASSOCIATE
KY
Enumeration date
02/08/2021
Last updated
02/08/2021
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