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Individual

DR. ERNESTO NILLAR-FONSECA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
9824 COLLIER LN, LOUISVILLE, KY 40291-3184
(502) 262-9487
Mailing address
9824 COLLIER LN, LOUISVILLE, KY 40291-3184
(502) 262-9487

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
20043751A
IN
103TC0700X
Clinical Psychologist
Primary
239702
KY

Other

Enumeration date
01/19/2009
Last updated
12/07/2023
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