Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 255150 | KY |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1255993184 |
---|---|
Provider Name | Kayce Fields |
First Address | Bowling Green, KY 42103-7956 |
Second Address | Glasgow, KY 42141-1561 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2019 |
Last Update Date | 14/09/2020 |