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Individual

MS. IDA B MARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPP

Contact information

Practice address
1113 CENTRE PKWY, LEXINGTON, KY 40517-3208
(859) 288-2425
(859) 721-2572
Mailing address
496 SOUTHLAND DR, LEXINGTON, KY 40503-1827
(859) 288-2392
(859) 721-2572

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0062
KY
103TC0700X
Clinical Psychologist
Primary
115837
KY

Other

Enumeration date
02/26/2008
Last updated
09/07/2021
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