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Individual

MR. WILLIE THOMAS BODDIE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
306 W MAIN ST, FRANKFORT, KY 40601-1895
(502) 385-2748
(502) 996-8400
Mailing address
306 W MAIN ST, FRANKFORT, KY 40601-1895
(502) 385-2748
(502) 996-8400

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1505
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100282590
KY
Enumeration date
08/23/2011
Last updated
05/23/2016
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