| NPI | 1083093298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA BERGMAN CEO 859-609-3893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY LPCPCC00216421) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |