| NPI | 1336695196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY BRYANT Owner 859-953-0119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY LPCPCC00218626) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |