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Organization
ALTA VISTA COUNSELING LLC
Active
Organization
ALTA VISTA COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SOUTHGATE CLAY EDINGER (CO-OWNER)
(502) 593-2618
Entity
Organization
Contact information
Practice address
130 FAIRFAX AVE LOWR LEVELC, LOUISVILLE, KY 40207-4939
(502) 593-2618
Mailing address
130 FAIRFAX AVE LOWR LEVELC, LOUISVILLE, KY 40207-4939
(502) 593-2618
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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