Individual
MR. WILLIAM ROBERT LIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
712 SUNRISE LN, ELIZABETHTOWN, KY 42701-2135
(270) 769-9150
Mailing address
712 SUNRISE LN, ELIZABETHTOWN, KY 42701-2135
(270) 769-9150
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
KY-0572
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY-0572
LMFT
KY
Enumeration date
06/26/2008
Last updated
06/26/2008
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