| NPI | 1184915019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE PATRICK WALTZ Marriage And Family Therapist 270-312-7752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KY 0765) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2011-04-26 |