| NPI | 1588361562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY ANN RICKETTS Owner 502-216-9458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2023-07-24 |