Provider Demographics
NPI:1730238171
Name:BLAISDELL CURRY, KATHLEEN DENISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:DENISE
Last Name:BLAISDELL CURRY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:DENISE
Other - Last Name:BLAISDELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:153 WILTSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3052
Mailing Address - Country:US
Mailing Address - Phone:502-896-2183
Mailing Address - Fax:
Practice Address - Street 1:1124 MEDICAL PL
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2640
Practice Address - Country:US
Practice Address - Phone:812-524-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041681A103TC0700X
KYKY-1230103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical