| NPI | 1861924953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN E PHELPS Co Owner 606-676-2513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY KY-0085) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |