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1184162224
REGINALD EZELL
LOUISVILLE, KY
NPI
1184162224
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY 119916)
Enumeration Date
2017-02-09
Last Update Date
2017-02-09
Business Address
-- REGINALD EZELL CADC
1017 W MARKET ST
LOUISVILLE, KY 40202
Phone number: 502-585-4848
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Mailing Address
-- REGINALD EZELL CADC
1020 W MARKET ST
LOUISVILLE, KY 40202-2630
Phone number: 502-585-4848
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