| NPI | 1861632622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA E. PENNINGTON Member/Owner 502-243-2622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3004525) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2015-09-01 |