Individual
MAKAYLA ELIZABETH JESSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 E FRAZIER AVE, COLUMBIA, KY 42728-1915
(270) 384-4719
Mailing address
130 SOUTHERN SCHOOL RD, SOMERSET, KY 42501-3223
(606) 679-4782
(606) 677-1746
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/02/2012
Last updated
11/09/2018
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