| NPI | 1184290264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA LYNN GILMORE Licensed Clinical Social Worker/ Ow 859-312-6569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-05-31 |
| Last Update Date | 2021-05-31 |