Doctor Name: | THOMAS BABICHUK |
NPI Number: | 1073723474 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 130 Vine Street Shepherdsville, KY - 40016 |
Business Phone Number: | 5025437033 |
Business Fax Number: | 5029559605 |
Mailing Address: | 101 W Muhammad Ali Blvd, LOUISVILLE |
State: | KY |
Postal Code: | 402021423 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |