Individual
MACI NEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BACHELOR'S
Contact information
Practice address
259 PARKERS MILL RD, SOMERSET, KY 42501-3152
(606) 679-7348
(606) 679-4097
Mailing address
130 SOUTHERN SCHOOL RD, SOMERSET, KY 42501-3223
(606) 679-4782
(606) 678-5296
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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