Individual
STEPHEN KENT BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1601 GREY OWL CT, LOUISVILLE, KY 40223-5599
(502) 287-3958
(502) 618-1242
Mailing address
1601 GREY OWL CT, LOUISVILLE, KY 40223-5599
(502) 287-3958
(502) 618-1242
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1335
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2081732
—
OH
05
—
89000996
—
KY
01
—
P00136138
RAILROAD MEDICARE
OH
Enumeration date
04/18/2006
Last updated
04/03/2015
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