Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 174223 | KY |
NPI | 1003174111 |
---|---|
Provider Name | Mrs. Heather Godwin Kirkland |
First Address | Versailles, KY 40383-1736 |
Second Address | Versailles, KY 40383-1736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2012 |
Last Update Date | 20/08/2019 |