| NPI | 1710493176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY L STEVENS Director Of Revenue 502-244-2441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 152W00000X Optometrist | |
| 213E00000X Podiatrist | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2021-10-29 |