Individual
JARED LEET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 825-6680
(270) 825-7266
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 326-3946
(270) 326-3954
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
244510
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100296660
—
KY
Enumeration date
10/20/2006
Last updated
07/11/2019
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