| NPI | 1386140358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MARIE SULLIVAN Clinical Director 502-417-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3275) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2022-06-10 |