Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 256157 | KY |
NPI | 1992462071 |
---|---|
Provider Name | Corbin Christine Jeffries |
First Address | Louisville, KY 40223-2612 |
Second Address | New Castle, KY 40050-6716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2021 |
Last Update Date | 23/11/2021 |