Individual
KYLIE QUALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2217 ICE HOUSE WAY, LEXINGTON, KY 40509-8637
(859) 230-8819
Mailing address
2217 ICE HOUSE WAY, LEXINGTON, KY 40509-8637
(859) 230-8819
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
260316
KY
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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