| NPI | 1811231897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SEGO TULLY Sole Member 270-307-3672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3167) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-05-02 |