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General NPI Number Information
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NPI Number | 1881342681
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Entity Type | Organization
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Legal Business Name | LIBBY ELDRIDGE MARRIAGE FAMILY THERAPY LLC
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 1711 BARDSTOWN RD STE 102
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City | LOUISVILLE
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State | KY
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Zip | 40205-1293
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Country | US
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Telephone | 502-314-8991
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Fax | 502-305-7113
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Provider Business Mailing Address
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Address Line | 1711 BARDSTOWN RD STE 102
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City | LOUISVILLE
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State | KY
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Zip | 40205-1293
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Country | US
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Telephone | 502-314-8991
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Fax | 502-305-7113
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Authorized Official
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Title or Position | MARRIAGE FAMILY THERAPIST
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Name | LIBBY ELDRIDGE
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Credential | MA LMFT
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Telephone | 502-314-8991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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