| NPI | 1346723178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DEATON Member 859-402-5892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2022-06-29 |