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Individual

MRS. KATIE R GANGLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
808 LYNDON LN STE 204, LOUISVILLE, KY 40222
(502) 314-2952
(502) 721-0321
Mailing address
4623 SHENANDOAH DR., LOUISVILLE, KY 40241
(502) 314-2952
(502) 721-0321

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3956
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100326520
KY
Enumeration date
02/11/2014
Last updated
06/05/2020
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