Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 104100000X | Social Worker |
NPI | 1003034950 |
---|---|
Provider Name | Lois Michelle Hubbard |
First Address | Corbin, KY 40702-0568 |
Second Address | Corbin, KY 40701-4811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/10/2009 |