Individual
MS. KRISTI JO JEDLICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2203 ARDSLEY RD, LOUISVILLE, KY 40207-1233
(502) 396-0216
Mailing address
2203 ARDSLEY RD, LOUISVILLE, KY 40207-1233
(502) 396-0216
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0147
KY
1041C0700X
Clinical Social Worker
Primary
0877
KY
Other
Enumeration date
02/02/2014
Last updated
02/02/2014
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