Individual
ERVINA DESAUSSURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4010 DUPONT CIR STE 202, LOUISVILLE, KY 40207-4847
(502) 326-3011
Mailing address
826 MARKHAM LN, LOUISVILLE, KY 40207-4445
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
294202
KY
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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