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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