| Doctor Name: | JENNIFER DIANE KEARNS |
| NPI Number: | 1174940647 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 2007018871 |
| Business Practice Address: | 210 E High St Suite 5 Potosi, MO - 636641909 |
| Business Phone Number: | 5736311516 |
| Business Fax Number: | |
| Mailing Address: | 586 W Capri Dr, BONNE TERRE |
| State: | MO |
| Postal Code: | 636289396 |
| Phone Number: | 5736311516 |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2014 |
| NPI Last Update Date: | 03/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2007018871 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |