Individual
TATJANA GABRIELLE LAUTERBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
835 HIGHLAND AVE, VINE GROVE, KY 40175-1562
(270) 352-1133
Mailing address
738 ANDRA DR, RADCLIFF, KY 40160-1880
(270) 317-4165
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
255320
KY
1041C0700X
Clinical Social Worker
Primary
257838
KY
Other
Enumeration date
10/04/2019
Last updated
03/14/2024
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