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NPI Code Detail

MEDICARE: LAUREN BROOKE FLAHERTY TLLP

MEDICARE: LAUREN BROOKE FLAHERTY TLLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist284414KY

General Provider Information

NPI Number : 1477109189
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN BROOKE FLAHERTY TLLP
Provider Business Mailing Address
First Line : 8007 LYNDON CENTRE WAY STE 101
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-3608
Country : US
Telephone Number : 502-690-8024
Fax Number :
Provider Business Practice Location Address
First Line : 8007 LYNDON CENTRE WAY STE 101
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-3608
Country : US
Telephone Number : 502-690-8024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2019
Last Update Date : 12/06/2023

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