| NPI | 1407089790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES I SHELTON Owner/President 859-296-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KY 02282) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2009-09-02 |