| NPI | 1083424261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY DANIELS Nurse Practitioner 502-956-4213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-01-10 |
| Last Update Date | 2025-03-29 |