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212 N 2nd St Ste 100 Richmond KY 40475-1408 | |
| (937) 516-1957 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 212 N 2nd St Ste 100, Richmond, Kentucky |
| Authorized Official Name and Position | Abishag Israel Douglas (OWNER/THERAPIST) |
| Authorized Official Contact | 9178320469 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4644 Powder Springs Dallas Rd Unit 904 Powder Springs GA 30127-7709 Ph: (937) 516-1957 | 212 N 2nd St Ste 100 Richmond KY 40475-1408 Ph: (937) 516-1957 |
| NPI Number | 1730845884 |
|---|---|
| Provider Enumeration Date | 11/12/2021 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730845884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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