Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | KY-1890 | KY |
Y | 101YP2500X | Professional Counselor | 173436 | KY |
NPI | 1003224452 |
---|---|
Provider Name | Amanda Jobe |
First Address | Somerset, KY 42501-3223 |
Second Address | Columbia, KY 42728-1915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2014 |
Last Update Date | 19/09/2018 |