| NPI | 1619693215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JO CLEMMONS Owner 502-291-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2023-06-28 |