Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003280710 |
---|---|
Provider Name | Kala Pinson |
First Address | Ashland, KY 41105-0790 |
Second Address | Ashland, KY 41102-5422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2015 |
Last Update Date | 18/11/2015 |