Provider Demographics
NPI:1386219343
Name:COULTER, JAMI A (MA)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:A
Last Name:COULTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:COULTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15705 N WABASH ST
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-9104
Mailing Address - Country:US
Mailing Address - Phone:502-408-7967
Mailing Address - Fax:
Practice Address - Street 1:9 VICTORY DR STE 1A
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3807
Practice Address - Country:US
Practice Address - Phone:816-368-1159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-23
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional