Individual
DR. SHAWN LYNETTE BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
833 CHESTNUT ST, SUITE 210, PHILADELPHIA, PA 19107-4414
(215) 955-8962
Mailing address
833 CHESTNUT ST, SUITE 210, PHILADELPHIA, PA 19107-4414
(215) 955-8962
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS016550
PA
103TC0700X
Clinical Psychologist
PS016550
PA
Other
Enumeration date
03/17/2009
Last updated
09/02/2010
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