Individual
MR. JILL DUBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LPCC, MFTA
Contact information
Practice address
1045 ELM ST, BOWLING GREEN, KY 42101-2513
(270) 843-1804
(270) 843-0154
Mailing address
2877 YEARLING AVE, BOWLING GREEN, KY 42101-0783
(270) 996-7396
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0819
KY
106H00000X
Marriage & Family Therapist
KY-04-0032
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
08/23/2007
Last updated
01/21/2009
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