Individual
BARBARA T BEAUCHAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
633 BAXTER AVE, LOUISVILLE, KY 40204-1157
(502) 309-2408
Mailing address
PO BOX 300, PROSPECT, KY 40059-0300
(502) 230-7599
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
129670
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129670
LICENSE
KY
Enumeration date
10/11/2011
Last updated
10/29/2020
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