Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker |
NPI | 1003425059 |
---|---|
Provider Name | Adrina Marie Colasanti |
First Address | Rineyville, KY 40162-9418 |
Second Address | Rineyville, KY 40162-9418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2020 |
Last Update Date | 05/08/2020 |