| NPI | 1699595116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRIN KEITH LEE Owner 502-384-9371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103T00000X Psychologist | |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 221700000X Art Therapist | |
| 224Z00000X Occupational Therapy Assistant | |
| 225A00000X Music Therapist | |
| 225X00000X Occupational Therapist | |
| 225XM0800X Occupational Therapist Mental Health | |
| 235Z00000X Speech-Language Pathologist | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-10-10 |