| NPI | 1508483512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SCHOENBAECHLER Credentialing Specialist 502-220-8437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2021-11-18 |