Individual
LIZA PURMORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1717 MADISON AVE, COVINGTON, KY 41011-3330
(859) 360-0250
Mailing address
1717 MADISON AVE, COVINGTON, KY 41011-3330
(859) 360-0250
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
118670
KY
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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