Individual
SALLY ROONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
520 VIOLET RD, CRITTENDEN, KY 41030-7480
(859) 428-4100
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184607
MEDICARE GROUP NUMBER
KY
Enumeration date
06/28/2006
Last updated
07/08/2007
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