| NPI | 1871864470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA JO NICHOLS Co Owner 606-388-4051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY Ky License #1170) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY Ky License #1040) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |