Provider Demographics
NPI:1871911370
Name:HORD, JILLIAN PAIGE (MFTA)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:PAIGE
Last Name:HORD
Suffix:
Gender:F
Credentials:MFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 BLUEGRASS DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-7005
Mailing Address - Country:US
Mailing Address - Phone:270-403-7668
Mailing Address - Fax:
Practice Address - Street 1:424 N BYPASS RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-7792
Practice Address - Country:US
Practice Address - Phone:270-043-7668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY08-031106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist