| NPI | 1699112623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN SMITH Director Of Operations 502-584-9781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: KY 100501) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY 100501) |
| 235Z00000X Speech-Language Pathologist (Licence: KY 100501) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2015-04-23 |