Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 3774 | KY |
NPI | 1003246422 |
---|---|
Provider Name | Mckenzie Danielle Linton |
First Address | Radcliff, KY 40160-2087 |
Second Address | Bardstown, KY 40004-9708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2013 |
Last Update Date | 02/01/2020 |