Facts
- Status
- A
- Credential
- M.Ed, LPCC
- Type
- Individual
- Enumeration date
- 2016-08-12
- Last updated
- 2021-03-29
Licenses
- License KY
- 168628
- License KY
- 168628
- License KY
- 269446
- License KY
- 269446
Location
- Practice location
- 451 BIG HILL AVE STE 5
- City
- RICHMOND KY
- Postal code
- 40475
- Phone
- 859-482-7862
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.