Individual
CARISSA STALLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1246 BRINDLE RIDGE RD, BRODHEAD, KY 40409-8412
(859) 230-6734
Mailing address
1246 BRINDLE RIDGE RD, BRODHEAD, KY 40409-8412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
294481
KY
Other
Enumeration date
06/09/2022
Last updated
02/24/2025
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