| NPI | 1093437865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN CHASE WILLIAMS Clinical Psychologist 502-314-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2022-09-25 |