Individual
JUSTIN WALDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
LEXINGTON VA MEDICAL CENTER, 1101 VETERAN'S DRIVE, LEXINGTON, KY 40502
(859) 233-4511
Mailing address
4051 WINNIPEG WAY, LEXINGTON, KY 40515-4631
(859) 457-1716
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5143
KY
Other
Enumeration date
01/06/2020
Last updated
02/12/2020
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