LARRY JOE BLUE

INDIANAPOLIS, IN
NPI1851906176
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN  86000347A)
Enumeration Date2020-09-14
Last Update Date2020-09-14
Business Address
LARRY JOE BLUE LAC, CHW, MATS, MTH
8202 CLEARVISTA PKWY
INDIANAPOLIS, IN 46256-1400
Phone number: 317-623-3007
Mailing Address
LARRY JOE BLUE LAC, CHW, MATS, MTH
8202 CLEARVISTA PKWY
INDIANAPOLIS, IN 46256-1400
Phone number: 317-623-3007