| NPI | 1659829760 |
|---|---|
| Doing Business As | MANDALA HOUSE |
| Entity Type | Organization |
| Authorized Contact | JACQUELYN GILLES Executive Director 502-309-2403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| 103T00000X Psychologist | |
| 103TC1900X Psychologist, Counseling | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2016-09-18 |
| Last Update Date | 2019-06-20 |