| NPI | 1700248028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTYN JACKSON Lmft 859-475-3482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY MFTMFT00220805) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2016-03-25 |