| NPI | 1912630245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK BACH Owner / Psychologist 502-203-0838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2022-07-05 |