| NPI | 1144418310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JINNY RAE VICROY Owner 859-276-1946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 1041085) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2007-10-12 |