Individual
AEON VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
U
Credential
LCSW
Contact information
Practice address
2020 NEWBURG RD, LOUISVILLE, KY 40205-1803
(502) 472-7293
Mailing address
2020 NEWBURG RD, LOUISVILLE, KY 40205-1803
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.1802969
OH
1041C0700X
Clinical Social Worker
Primary
256742
KY
Other
Enumeration date
10/22/2018
Last updated
02/09/2025
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