Individual
ESTEFANIA RETALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3717 TAYLORSVILLE RD, 1ST FLOOR, LOUISVILLE, KY 40220-1333
(502) 589-8600
(502) 589-8771
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/18/2012
Last updated
06/03/2024
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