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General NPI Number Information
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NPI Number | 1942666094
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Entity Type | Individual
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Provider Name | AUDRA J HARLEY LPCC
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Gender | Female
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 100 W 3RD ST STE 304
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City | OWENSBORO
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State | KY
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Zip | 42303-4129
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Country | US
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Telephone | 270-925-8958
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Fax | 270-698-9778
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Provider Business Mailing Address
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Address Line | 100 W 3RD ST STE 304
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City | OWENSBORO
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State | KY
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Zip | 42303-4129
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Country | US
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Telephone | 270-925-8958
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Fax | 270-698-9778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 164690
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 242158
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License Number State | KY
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