Individual
CARSYN GRAE KIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT ASSOCIATE
Contact information
Practice address
120 SEARS AVE STE 205, LOUISVILLE, KY 40207-5072
(502) 438-8656
Mailing address
120 SEARS AVE STE 205, LOUISVILLE, KY 40207-5072
(502) 438-8656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
285983
KY
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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