Basic Information
| Provider Information | |||||||||
| NPI: | 1184133324 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KINTNER | ||||||||
| FirstName: | LAURA | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10101 LINN STATION RD | ||||||||
| Address2: | #600 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025898600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4710 CHAMPIONS TRACE | ||||||||
| Address2: | #107 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024546343 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2017 | ||||||||
| LastUpdateDate: | 09/20/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 174460 | KY | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.