| NPI | 1740919281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE MARIE DAVIS GOODWINE Clinical Psychologist 502-276-5096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 171M00000X Case Manager/Care Coordinator | |
| 224Z00000X Occupational Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-06-09 |