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1396202727
JEROD MITCHELL THOMAS
LEXINGTON, KY
NPI
1396202727
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY 166725)
Enumeration Date
2019-02-21
Last Update Date
2019-02-21
Business Address
JEROD MITCHELL THOMAS CADC
635 MAXWELTON CT
LEXINGTON, KY 40508-4012
Phone number: 859-252-1939
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Mailing Address
JEROD MITCHELL THOMAS CADC
635 MAXWELTON CT
LEXINGTON, KY 40508-4012
Phone number: 859-252-1939
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