| NPI | 1972346401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN MILES Psychologist 859-379-9721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-08-26 |