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Individual

LATASHA YOUNGBLOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2025 BYPASS RD, BRANDENBURG, KY 40108-1605
(270) 422-3971
Mailing address
2025 BYPASS RD, BRANDENBURG, KY 40108-1605

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30605018
KY
Enumeration date
02/23/2018
Last updated
02/23/2018
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