Individual
DEANNA WATHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1907 BARDSTOWN RD, LOUISVILLE, KY 40205-1525
(502) 653-9299
Mailing address
901 MCKINLEY AVE, LOUISVILLE, KY 40217-2021
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
292256
KY
101YP2500X
Professional Counselor
292256
KY
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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