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General NPI Number Information
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NPI Number | 1851150841
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Entity Type | Organization
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Legal Business Name | SOLACE KY
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 93 OLD CLEAR SPRINGS RD
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City | JAMESTOWN
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State | KY
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Zip | 42629-2425
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Country | US
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Telephone | 859-493-1593
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Fax | 463-218-9161
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Provider Business Mailing Address
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Address Line | 93 OLD CLEAR SPRINGS RD
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City | JAMESTOWN
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State | KY
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Zip | 42629-2425
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Country | US
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Telephone | 859-493-1593
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Fax | 463-218-9161
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | ANGELA AARON
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Credential | PHD
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Telephone | 859-493-1593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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