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General NPI Number Information
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NPI Number | 1023594934
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Entity Type | Organization
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Legal Business Name | AAFREEL, LLC DBA KENTUCKY PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 606 S DOGWOOD DR
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City | BEREA
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State | KY
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Zip | 40403-9520
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Country | US
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Telephone | 859-200-1990
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Fax |
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Provider Business Mailing Address
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Address Line | 606 S DOGWOOD DR
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City | BEREA
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State | KY
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Zip | 40403-9520
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Country | US
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Telephone | 859-200-1990
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANNETTE FREEL
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Credential | LP
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Telephone | 859-200-1990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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