| NPI | 1043910631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA WARREN Director Of Credentialng 502-381-3338 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2023-08-07 |