Individual
ETHAN PENDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BIS
Contact information
Practice address
1100 WALNUT ST, OWENSBORO, KY 42301-2956
(270) 689-6578
Mailing address
1107 S KENTUCKY AVE, EVANSVILLE, IN 47714-2737
(270) 485-4242
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9585
KY
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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