| NPI | 1780865907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE W CARLSON Clinical Neuropsychologist 502-352-2446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY KY-1384) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: KY KY-1384) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2007-11-15 |