| NPI | 1295879765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON VOOR Psychologist 502-899-9470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: KY KY966) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KY KY966) |
| 103TC0700X Psychologist, Clinical (Licence: KY KY966) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY KY966) | |
| 103T00000X Psychologist (Licence: KY KY966) | |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2020-08-22 |