Individual
MR. KEVIN R BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, JSOCCP
Contact information
Practice address
3484 GLEN LILY RD, BOWLING GREEN, KY 42101-7849
(334) 441-6165
Mailing address
3484 GLEN LILY RD, BOWLING GREEN, KY 42101-7849
(334) 441-6165
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
258181
KY
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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