| NPI | 1730136995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC F. LYDON Owner 502-894-6066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 39958) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 3479) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-01-15 |