Organization
MOBILE PSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RITA MARIE JUNGBLOM PSY.D. (OWNER)
(270) 875-2544
Entity
Organization
Contact information
Practice address
345 LEROY ROAD, HANSON, KY 42413-9657
(270) 875-2544
(270) 342-5411
Mailing address
345 LEROY ROAD, HANSON, KY 42413-9657
(270) 875-2544
(270) 342-5411
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1355
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100240540
—
KY
05
—
7100297310
—
KY
Enumeration date
10/05/2012
Last updated
09/15/2014
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