Individual
RAVEN ROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
455 PARK PL STE 130, LEXINGTON, KY 40511-1830
(859) 276-0533
Mailing address
455 PARK PLACE, SUITE 130, LEXINGTON, KY 40511
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/10/2017
Last updated
06/16/2018
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