Individual
KENDRA RAE MARCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 ROACH ST, GEORGETOWN, KY 40324-9393
(502) 863-4734
(502) 863-4735
Mailing address
110 ROACH ST, GEORGETOWN, KY 40324-9393
(502) 863-4735
(502) 863-4735
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
05/16/2023
Last updated
05/16/2023
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