is a Psychiatric/mental Health in , . practices all healthcare services and medical treatments related to Psychiatric/mental Health. The NPI Number for is 1164572475. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1164572475 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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| Phone Number | |
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Provider's Primary Taxonomy Detail
| Speciality | Psychiatric/mental Health |
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| Taxonomy | 163Wp0808X |
| Licence No | 11770403 |
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Definition: A registered nurse who cares for patients with mental health disorders and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 30615058 | KY | -- |
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