Individual
CHANEL D BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
4124 KATHERINE PL, LEXINGTON, KY 40515-4000
(502) 209-8025
Mailing address
2081 HARRODSBURG RD # 1117, LEXINGTON, KY 40504-3503
(502) 209-8025
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
256436
KY
Other
Enumeration date
01/11/2022
Last updated
03/22/2023
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