| NPI | 1346631512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LEE Therapist 859-494-2388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 6157) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 1297) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2018-09-19 |