Organization
LAKE CUMBERLAND PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA C JONES PT (EXECUTIVE DIRECTOR)
(606) 425-4371
Entity
Organization
Contact information
Practice address
67 JACKS LN, SOMERSET, KY 42501-6152
(606) 425-4371
(606) 699-1669
Mailing address
67 JACKS LN, SOMERSET, KY 42501-6152
(606) 425-4371
(606) 699-1669
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/21/2020
Last updated
09/28/2020
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