NPI | 1972827707 |
---|---|
Entity Type | Organization |
Authorized Contact | SALVATORE J BERTOLONE President 502-629-7751 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 1505) |
Enumeration Date | 2010-03-23 |
Last Update Date | 2010-03-23 |