| NPI | 1518369040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE HICKERSON Clinical Director 270-996-5877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3394) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-09-16 |