Individual
ERICA LYNN VICE PRISTAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2689 FRANKFORT RD, GEORGETOWN, KY 40324-8611
(859) 537-9779
(859) 868-9312
Mailing address
2689 FRANKFORT RD, GEORGETOWN, KY 40324-8611
(859) 537-9779
(859) 868-9312
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
KY-1555
KY
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
KY-1555
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100289550
—
KY
Enumeration date
07/18/2008
Last updated
03/17/2018
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