Individual
LOIS JANE DOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPA
Contact information
Practice address
1203 AMERICAN GREETING CARD RD, CORBIN, KY 40701-4811
(606) 528-7010
Mailing address
PO BOX 568, CORBIN, KY 40702-0568
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
2008-105
KY
103TC1900X
Counseling Psychologist
Primary
KY-0940
KY
Other
Enumeration date
03/09/2009
Last updated
01/16/2014
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