Organization
BLANFORD PEDIATRIC THERAPY LLC
Active
Other names
Lemon-Aid Mental Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE BOLTWOOD (BILLING MANAGER)
(770) 530-9051
Entity
Organization
Contact information
Practice address
201 S 5TH ST, BARDSTOWN, KY 40004-1142
(502) 331-5478
(502) 385-0234
Mailing address
201 S 5TH ST, BARDSTOWN, KY 40004-1142
(502) 331-5478
(502) 385-0234
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100424590
—
KY
Enumeration date
12/04/2017
Last updated
08/31/2023
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