Organization
FRONTIER PSYCHOLOGICAL ASSOCIATES, L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIET L JETT PH.D. (CO-OWNER)
(307) 789-6773
Entity
Organization
Contact information
Practice address
724 FRONT STREET, SUITE 230, EVANSTON, WV 82930
(307) 789-6773
(307) 789-3244
Mailing address
724 FRONT STREET, SUITE 230, EVANSTON, WV 82930
(307) 789-6773
(307) 789-3244
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103T00000X
Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110414403
—
WY
Enumeration date
01/10/2007
Last updated
08/29/2022
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