Individual
JACQUELINE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
4010 DUPONT CIR STE 419, LOUISVILLE, KY 40207-4837
(502) 409-6993
(502) 409-6775
Mailing address
4010 DUPONT CIR STE 419, LOUISVILLE, KY 40207-4837
(502) 409-6993
(502) 409-6775
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
268769
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610661458
TAX ID
KY
Enumeration date
02/09/2018
Last updated
02/14/2023
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