Individual
PRISCILLA PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
561 N LAKE DR, PRESTONSBURG, KY 41653-1278
(606) 216-1152
Mailing address
561 N LAKE DR, PRESTONSBURG, KY 41653-1278
(606) 216-1152
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1041C0700X
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
KY
Enumeration date
11/13/2013
Last updated
11/13/2013
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