Individual
TIA AILEEN NICHOLAS PANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
8134 NEW LA GRANGE RD STE 100, LOUISVILLE, KY 40222-4677
(502) 472-7293
(502) 690-4500
Mailing address
8134 NEW LA GRANGE RD STE 100, LOUISVILLE, KY 40222-4677
(502) 472-7293
(502) 690-4500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
260211
KY
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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