| NPI | 1700494598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOCCARA C COLEMAN Billing Specialist 859-251-4353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2021-04-01 |