| NPI | 1104331156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA THOMASON PAUL Licensed Clinical Social Worker 502-640-3940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3813) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |