| Ml Cantrell Psychotherapeutic Services, Pllc | |
|
1219 W Main St West Liberty KY 41472-2161 | |
| (606) 743-2407 | |
| Not Available |
| Full Name | Ml Cantrell Psychotherapeutic Services, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1219 W Main St, West Liberty, Kentucky |
| Authorized Official Name and Position | Mary Lou Cantrell (SOLE OWNER) |
| Authorized Official Contact | 6067432407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ml Cantrell Psychotherapeutic Services, Pllc 849 Highway 191 West Liberty KY 41472-8315 Ph: (606) 743-2407 | Ml Cantrell Psychotherapeutic Services, Pllc 1219 W Main St West Liberty KY 41472-2161 Ph: (606) 743-2407 |
| NPI Number | 1467851667 |
|---|---|
| Provider Enumeration Date | 08/14/2014 |
| Last Update Date | 08/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467851667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSYPPR00193411 (Kentucky) | Primary |
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