| NPI | 1720326341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE SUE EDLIN Developmental Interventionist 270-763-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: KY 200402743) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: KY 200402743) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2014-11-17 |