| Doctor Name: | DR. JEAN A DETERS |
| NPI Number: | 1710043203 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 1391 |
| Business Practice Address: | 34 Erlanger Rd Erlanger, KY - 410181728 |
| Business Phone Number: | 8593415782 |
| Business Fax Number: | 8593415783 |
| Mailing Address: | 34 Erlanger Rd, ERLANGER |
| State: | KY |
| Postal Code: | 410181728 |
| Phone Number: | 8593415782 |
| Fax Number: | 8593415783 |
| NPI Enumeration Date: | 12/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1391 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |