| NPI | 1255755120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA LOUISE PETERSON Clinical Psychologist/President 502-721-0435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 1472) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2014-02-12 |