Graduated: 2004
NPI: 1205179009
Practice Locations (2)
LAKE CUMBERLAND REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC .
200 E FRAZIER AVE
COLUMBIA, KY 427281915
2703844719
LAKE CUMBERLAND REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC .
259 PARKERS MILL RD
SOMERSET, KY 425013152
6066797348
Source: CMS National Downloadable File, September 2026.