Individual
PENELOPE BACK LENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPAT
Contact information
Practice address
128 N CLIFTON AVE, LOUISVILLE, KY 40206-2402
(502) 468-5429
Mailing address
128 N CLIFTON AVE, LOUISVILLE, KY 40206-2402
(502) 468-5429
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
KY-0154
KY
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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