Individual
MARY JENNIFER STAMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ICADC
Contact information
Practice address
1589 HILL RISE DR, LEXINGTON, KY 40504-2588
(859) 977-2505
Mailing address
313 LILAC CT, VERSAILLES, KY 40383-9292
(859) 333-0419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0920
KY
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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