Most Relevant Information
Provider Data
| NPI Number: | 1003303884 |
| Provider Name: | GATT READ WARE TLCADC, BIP |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 164501 |
Most Important Dates
| Enumeration Date: | 04/17/2018 |
| Last Updated: | 04/17/2018 |
Provider Practice Location
1043 PEDIGO WAY STE 30
BOWLING GREEN
KY
421036124
Practice Location Phone/Fax
| Phone: | 2704951224 |
| Fax: | 2705990023 |
Provider Mailing Location
1043 PEDIGO WAY STE 30
BOWLING GREEN
KY
421036124
Provider Mailing Phone/Fax
| Phone: | 2704951224 |
| Fax: | 2705990023 |