| NPI | 1669985800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DW SIMMONS Provider/Owner 859-805-0188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 1106) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2020-11-06 |