Individual
CHARLES DAVID MEDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3150 CUSTER DR., SUITE203, LEXINGTON, KY 40517
(859) 271-7788
(859) 273-3306
Mailing address
3150 CUSTER DR., SUITE203, LEXINGTON, KY 40517
(859) 271-7788
(859) 273-3306
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
144
KY
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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