| NPI | 1629773338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LEWIS Owner 502-777-2397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2025-02-13 |