| NPI | 1407024664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH H HERSH Director 502-852-7897 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KY 20137) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: KY 1085) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: KY R0815) | |
| 235Z00000X Speech-Language Pathologist, (Licence: KY 583) | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-11 |