Organization
LK CHILD AND FAMILY THERAPY, LLC
Active
Organization
LK CHILD AND FAMILY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MINNICK (OFFICE MANAGER)
(812) 828-7637
Entity
Organization
Contact information
Practice address
3806 SOUTHLAND AVE STE B, KOKOMO, IN 46902-3833
(765) 860-1229
Mailing address
3806 SOUTHLAND AVE STE B, KOKOMO, IN 46902-3833
(765) 860-1229
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
35001637A
IN
251S00000X
Community/Behavioral Health Agency
39001655A
IN
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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