Doctor Name: | JODI LEIGH CLINE |
NPI Number: | 1104158641 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MHC |
License Number: | 101YM0800X |
Business Practice Address: | 200 River Rd Ligonier, IN - 467679537 |
Business Phone Number: | 2608944035 |
Business Fax Number: | |
Mailing Address: | 200 River Rd, LIGONIER |
State: | IN |
Postal Code: | 467679537 |
Phone Number: | 2608944035 |
Fax Number: | |
NPI Enumeration Date: | 02/09/2010 |
NPI Last Update Date: | 02/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 101YM0800X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |