Organization
ML CANTRELL PSYCHOTHERAPEUTIC SERVICES, PLLC
Active
Organization
ML CANTRELL PSYCHOTHERAPEUTIC SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY LOU CANTRELL MA, LPP (SOLE OWNER)
(606) 743-2407
Entity
Organization
Contact information
Practice address
1219 W MAIN ST, WEST LIBERTY, KY 41472-2161
(606) 743-2407
Mailing address
849 HIGHWAY 191, WEST LIBERTY, KY 41472-8315
(606) 743-2407
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSYPPR00193411
KY
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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