Individual
MRS. MARY ELIZABETH HANNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 BEASLEY ST, #120, LEXINGTON, KY 40509-4266
(859) 254-1035
Mailing address
590 PLAINVIEW RD, LEXINGTON, KY 40517-4254
(540) 533-4602
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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