| NPI | 1659381580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL F. VASQUEZ Owner 606-878-1961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 35016) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 35016) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3220P) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2010-01-05 |