| NPI | 1457539140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL THOMAS Business Administrator 502-588-4426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 103TC0700X Psychologist, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2014-05-22 |