Individual
VANESSA SIERRA BLOODWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 699-9151
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
KY
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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