Organization
PRIVATE CONTRACTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA KENISE GRANT (DEVELOPMENTAL ASSOCIATE)
(270) 634-7733
Entity
Organization
Contact information
Practice address
301 EUNICE DUNNVILLE RD, COLUMBIA, KY 42728-9131
(270) 634-7733
Mailing address
301 EUNICE DUNNVILLE RD, COLUMBIA, KY 42728-9131
(270) 634-7733
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/25/2009
Last updated
08/25/2009
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