Individual
KATHLEEN VANESSA BLADES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
540 BAXTER AVE, LOUISVILLE, KY 40204-1154
(502) 694-9488
(502) 785-4201
Mailing address
540 BAXTER AVE, LOUISVILLE, KY 40204-1154
(270) 210-9755
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
242124
KY
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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