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1861547218
KEITH BANTA
LOUISVILLE, KY
NPI
1861547218
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: KY 1194)
Enumeration Date
2007-01-24
Last Update Date
2007-07-08
Business Address
Mr. KEITH BANTA LCSW
3430 NEWBURG RD SUITE 212
LOUISVILLE, KY 40218-2497
Phone number: 502-454-8800
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Mailing Address
Mr. KEITH BANTA LCSW
3430 NEWBURG RD SUITE 212
LOUISVILLE, KY 40218-2497
Phone number: 502-454-8800
Copy
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