| NPI | 1760264675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE J CLEMMONS Counselor 502-291-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 221700000X Art Therapist | |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |