| NPI | 1104434612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY A JOHNSON Owner 502-744-2460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 103K00000X Behavior Analyst | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |