Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 1041C0700X | Clinical Social Worker | 253141 | KY |
NPI | 1003228222 |
---|---|
Provider Name | Miss Cymbre Lin Root |
First Address | Lexington, KY 40507-1027 |
Second Address | Lexington, KY 40507-1027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2014 |
Last Update Date | 19/10/2020 |