Doctor Name: | JODY L JARRETT |
NPI Number: | 1992867972 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2005038673 |
Business Practice Address: | 600 N Main St Mountain Grove, MO - 657111309 |
Business Phone Number: | 4179267623 |
Business Fax Number: | 4179267650 |
Mailing Address: | 600 N Main St, MOUNTAIN GROVE |
State: | MO |
Postal Code: | 657111309 |
Phone Number: | 4179267623 |
Fax Number: | 4179267650 |
NPI Enumeration Date: | 12/15/2006 |
NPI Last Update Date: | 04/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2005038673 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |