| NPI | 1386706893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE M MANGOLD Owner 859-512-0334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 193400000x) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2018-03-17 |