Individual
JULIANA LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 CADBURY CT, LOUISVILLE, KY 40212-1770
(502) 975-0394
Mailing address
405 CADBURY CT, LOUISVILLE, KY 40212-1770
(502) 975-0394
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1197269
KY
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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