Organization
LIVEWISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY ANTHONY HALL LCSW (OWNER)
(502) 510-3630
Entity
Organization
Contact information
Practice address
103 ENGLEWOOD DR, BARDSTOWN, KY 40004-2520
(502) 510-3630
Mailing address
103 ENGLEWOOD DR, BARDSTOWN, KY 40004-2520
(502) 510-3630
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
KY-1412
KY
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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