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Individual

SUMNER-RAE LAGOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LPCC, NCC

Contact information

Practice address
7410 NEW LAGRANGE RD, SUITE 204, LOUISVILLE, KY 40222
(209) 743-2480
Mailing address
7002 INKBERRY CT APT 1, LOUISVILLE, KY 40291-5715
(209) 743-2480

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
127690
KY
101YM0800X
Mental Health Counselor
127690
KY
101YP2500X
Professional Counselor
Primary
127690
KY

Other

Enumeration date
06/27/2016
Last updated
10/27/2016
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