| NPI | 1215112297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY RAY FRAGER Clinical Psychologist 502-426-4716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 0516) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: KY 1356) |
| 103T00000X Psychologist (Licence: KY 0713) | |
| 103T00000X Psychologist (Licence: KY 1166) | |
| 1041C0700X Social Worker, Clinical (Licence: KY 1880) | |
| 1041C0700X Social Worker, Clinical (Licence: KY 1954) | |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2013-06-14 |