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Individual

MIKAYLA'LYNN WIENTJES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
911 LILY CREEK RD, LOUISVILLE, KY 40243-2808
(502) 242-7620
Mailing address
127 QUICK RD, NEW CARLISLE, OH 45344-9253

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
06/03/2022
Last updated
06/03/2022
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