| NPI | 1134443963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALVATORE J BERTOLONE President 502-629-7751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 1505) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2010-03-23 |