| Doctor Name: | MRS. JESSICA RENE' WELLS |
| NPI Number: | 1205115201 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCA |
| License Number: | KY- 1064 |
| Business Practice Address: | 70 Main St Frenchburg, KY - 403228318 |
| Business Phone Number: | 6067682131 |
| Business Fax Number: | |
| Mailing Address: | Po Box 790, ASHLAND |
| State: | KY |
| Postal Code: | 411050790 |
| Phone Number: | 6063298588 |
| Fax Number: | 6063298195 |
| NPI Enumeration Date: | 08/08/2011 |
| NPI Last Update Date: | 04/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | KY- 1064 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |