Individual
NINA MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 CORTLAND CT, ELIZABETHTOWN, KY 42701-6481
(270) 304-9324
Mailing address
107 CORTLAND CT, ELIZABETHTOWN, KY 42701-6481
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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