| NPI | 1457708729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON SHY Billing Manager 502-454-7766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY LPCCCA00224155) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2016-05-17 |