| NPI | 1346033776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE RICE Owner/Provider 502-439-6251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-11-21 |