Organization
KIM SEGO TULLY, LCSW, PSYCHOTHERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY SEGO TULLY LCSW (SOLE MEMBER)
(270) 307-3672
Entity
Organization
Contact information
Practice address
240 W DIXIE AVE, SUITE 5-B, ELIZABETHTOWN, KY 42701-1586
(270) 307-3672
Mailing address
589 RUE LA GRANDE, ELIZABETHTOWN, KY 42701-3135
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3167
KY
Other
Enumeration date
11/15/2012
Last updated
05/02/2017
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