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Individual

DR. ANDREA OMIDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
715 SHAKER DR, SUITE 132, LEXINGTON, KY 40504-3662
(859) 913-4825
Mailing address
715 SHAKER DR, SUITE 132, LEXINGTON, KY 40504-3662
(859) 913-4825

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
1749
KY
103TC0700X
Clinical Psychologist
Primary
1749
KY
103TC1900X
Counseling Psychologist
1749
KY
103TC2200X
Clinical Child & Adolescent Psychologist
1749
KY
103TF0000X
Family Psychologist
1749
KY
103TH0004X
Health Psychologist
1749
KY
103TP2701X
Group Psychotherapy Psychologist
1749
KY

Other

Enumeration date
11/11/2011
Last updated
04/10/2014
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