| NPI | 1205226982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE WIGGINTON Clinical Director 270-691-0501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 6134) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |