| NPI | 1790763605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH H HERSH Medical Director 502-852-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 207SG0201X Medical Genetics Clinical Genetics (M.D.) | |
| 208000000X Pediatrics | |
| 2080P0008X Pediatrics Neurodevelopmental Disabilities | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2013-03-06 |