Individual
KEVIN BLAKE JUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 GIBSON LN, RICHMOND, KY 40475-2577
(859) 626-5030
(859) 626-8020
Mailing address
411 GIBSON LN, RICHMOND, KY 40475-2577
(859) 626-5030
(859) 626-8020
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
05/03/2022
Last updated
06/30/2023
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