Doctor Name: | AMANDA JOBE |
NPI Number: | 1003224452 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | KY-1890 |
Business Practice Address: | 331 S 3rd St Bardstown, KY - 400041032 |
Business Phone Number: | 5023480585 |
Business Fax Number: | |
Mailing Address: | 711 Mitchell St, COLUMBIA |
State: | KY |
Postal Code: | 427281639 |
Phone Number: | 2706341213 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2014 |
NPI Last Update Date: | 07/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | KY-1890 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |