| NPI | 1720762115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON FORD CEO 859-300-9760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 103TC0700X Psychologist, Clinical | |
| 225X00000X Occupational Therapist | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2025-11-22 |