Individual
LAURA A GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
118 WEST UNION ST, MUNFORDVILLE, KY 42765
(270) 524-9883
(270) 524-0437
Mailing address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000
(270) 842-5268
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3153
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100291210
—
KY
Enumeration date
02/09/2007
Last updated
12/18/2017
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