| NPI | 1982182317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MATTHEWS Owner 270-775-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3002835) |
| Enumeration Date | 2018-07-28 |
| Last Update Date | 2018-08-29 |