Individual
JASON ROBIN GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPA
Contact information
Practice address
380 SUWANNEE TRAIL STREET, BOWLING GREEN, KY 42103
(270) 901-5000
(270) 782-5927
Mailing address
3109 DEVONSHIRE PL, BOWLING GREEN, KY 42104-4593
(270) 901-5000
(270) 842-5268
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
08/04/2006
Last updated
04/04/2008
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