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Organization

A NEW ORDER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TUYHIEP MONICA LAWRENCE (DIRECTOR OF OPERATIONS)
(502) 618-0397
Entity
Organization

Contact information

Practice address
4335 HAZELWOOD AVE, LOUISVILLE, KY 40215-1111
(502) 618-0397
Mailing address
4335 HAZELWOOD AVE, LOUISVILLE, KY 40215-1111
(502) 618-0397

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
06/16/2023
Last updated
06/16/2023
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