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Individual

NICHOLAS WAYNE BLOODWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
441 E 80 DR, COLUMBIA, KY 42728-8927
(270) 250-5264
Mailing address
441 E 80 DR, COLUMBIA, KY 42728-8927
(270) 250-5264

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
240324
KY

Other

Enumeration date
04/21/2015
Last updated
04/18/2018
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