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1104207042
JAY DEITERS
LEXINGTON, KY
NPI
1104207042
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC1900X Psychologist, Counseling
(Licence: KY PSYPST00213906)
Enumeration Date
2015-06-16
Last Update Date
2015-06-16
Business Address
-- JAY DEITERS
1101 VETERANS DR
LEXINGTON, KY 40502-2235
Phone number: 859-233-4511
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Mailing Address
-- JAY DEITERS
1101 VETERANS DR
LEXINGTON, KY 40502-2235
Phone number:
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