| NPI | 1104198902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE ANN JARRELL Licensed Clinical Social Worker 502-609-0062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: KY ky-3213) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |