| NPI | 1154542959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY L SHEPPARD President Psychologist 502-893-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 1324) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |