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General NPI Number Information
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NPI Number | 1992345169
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Entity Type | Organization
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Legal Business Name | GROWING MINDS LLC
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 308 KENNETH MOORE LN
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City | HUDSON
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State | KY
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Zip | 40145-7870
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Country | US
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Telephone | 270-668-4237
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Fax |
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Provider Business Mailing Address
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Address Line | 308 KENNETH MOORE LN
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City | HUDSON
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State | KY
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Zip | 40145-7870
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Country | US
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Telephone | 270-668-4237
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Fax |
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Authorized Official
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Title or Position | EARLY INTERVENTION PROVIDER
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Name | DONNA J SMALLWOOD
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Credential |
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Telephone | 270-668-4237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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