Organization
PSYCHOLOGICAL SERVICES AND SUPPORT OF THE BLUEGRASS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA GRANGER (OWNER)
(859) 338-9516
Entity
Organization
Contact information
Practice address
151 PROSPEROUS PL STE 1B, LEXINGTON, KY 40509-2180
(859) 338-9516
Mailing address
151 PROSPEROUS PL STE 1B, LEXINGTON, KY 40509-2180
(859) 338-9516
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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