Most Relevant Information
Provider Data
| NPI Number: | 1003682469 |
| Provider Name: | JEANINE PERRY |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/28/2023 |
| Last Updated: | 11/28/2023 |
Provider Practice Location
60 PROFESSIONAL PARK DR
LOUISA
KY
412309644
Practice Location Phone/Fax
| Phone: | 6063560129 |
| Fax: |
Provider Mailing Location
PO BOX 790
ASHLAND
KY
411050790
Provider Mailing Phone/Fax
| Phone: | 6063298195 |
| Fax: |