Individual
MADISON SURRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2321 LIME KILN LN STE B, LOUISVILLE, KY 40222-3410
(502) 771-1183
Mailing address
13764 HIGHWAY 44 E, TAYLORSVILLE, KY 40071-7933
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
278627
KY
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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