Healthcare Provider Details
I. General information
NPI: 1447494026
Provider Name (Legal Business Name): JENNIFER DEMLING CEBE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2009
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7980 NEW LA GRANGE RD SUITE 7
LOUISVILLE KY
40222-4767
US
IV. Provider business mailing address
7980 NEW LA GRANGE RD SUITE 7
LOUISVILLE KY
40222-4767
US
V. Phone/Fax
- Phone: 502-412-9203
- Fax: 502-412-9204
- Phone: 502-412-9203
- Fax: 502-412-9204
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 1270 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: