| NPI | 1396582698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRICA TAMAR SMITH Director Of Operations 502-888-6688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-12 |