| NPI | 1508277864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA A BROWN Member 502-235-2428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 133V00000X Dietitian, Registered | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2020-04-16 |