| NPI | 1750836136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA LANGOLF Member 502-817-0927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34007247A) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-16 |