| NPI | 1609385236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LEWIS Owner 502-777-2397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KY 165432) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2023-04-10 |