| NPI | 1649208331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONDA L MANCINI Owner 502-394-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KY LCSW726) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY KY1228) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2020-08-22 |