Provider Information for 1194972141
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Mrs. JETONA K MILBY LMFT
Sex: Female
NPI: 1194972141
Last Updated: 2019-09-04
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1194972141 | ||||||||||||
| Enumeration Date | 2008-08-21 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 104 E MAIN ST STE 99 HODGENVILLE, KY 42748-1334 United States Phone: 270-358-6131 | Fax:270-358-6582 | ||||||||||||
| Primary Practice Address | 104 E MAIN ST STE 99 HODGENVILLE, KY 42748-1334 United States Phone: 270-358-6131 | Fax:270-358-6582 | ||||||||||||
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