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Individual

GARY SANTANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS/CADC

Contact information

Practice address
340 LEGION DR STE 28, LEXINGTON, KY 40504-2716
(859) 276-0533
Mailing address
PO BOX 11161, LEXINGTON, KY 40574-1161
(859) 230-7073

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1016
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
165945
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100590860
KY
Enumeration date
01/08/2015
Last updated
03/09/2021
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