| NPI | 1841498698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L. KIMES Exec. Director Of Clinical Services 502-495-5088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 103T00000X Psychologist (Licence: KY KY-1424) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2017-09-12 |