Individual
JENNIFER O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
201 E 2ND ST, SUITE B, TOMPKINSVILLE, KY 42167-1673
(270) 487-5655
(270) 487-5948
Mailing address
609 BUCK CREEK RD, SMITHS GROVE, KY 42171-9284
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0578
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
05/01/2007
Last updated
07/08/2007
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