Individual
JENNY BARDENA DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
189 KY-192, LONDON, KY 40741
(606) 657-5470
Mailing address
PO BOX 303, EAST BERNSTADT, KY 40729-0303
(606) 312-2437
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
246663
KY
101YP2500X
Professional Counselor
Primary
268211
KY
Other
Enumeration date
10/09/2019
Last updated
04/29/2022
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