Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003474131 |
---|---|
Provider Name | Carolyn Nickole Meiman |
First Address | Louisville, KY 40216-2813 |
Second Address | Jeffersonville, IN 47130-3452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2019 |
Last Update Date | 04/06/2019 |