| NPI | 1154448645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA R. VAVRO Mental Health Therapist 502-495-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 0811) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 1900) |
| 1041C0700X Social Worker, Clinical (Licence: KY 1329) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |