Graduated: 2021
NPI: 1306506217
Practice Locations (2)
NORTHERN KENTUCKY MENTAL HEALTH MENTAL RETARDATION REGIONAL BOARD
513 MADISON AVE, FL 1
COVINGTON, KY 410111535
8595783200
KIOSK MEDICINE KENTUCKY LLC
1700 DECLARATION DR
INDEPENDENCE, KY 410518441
8598981608
Source: CMS National Downloadable File, September 2026.