| NPI | 1326695255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY GAST Syst VP Of Mngd Care & Payor Strat 502-272-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist Clinical | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 104100000X Social Worker | |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant Medical | |
| 363AS0400X Physician Assistant Surgical | |
| 2080A0000X Pediatrics Adolescent Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| 208000000X Pediatrics | |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2021-12-10 |