| NPI | 1629518600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THREASE STUCKER Executive Director/Owner 502-437-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2018-02-08 |