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1851906176
LARRY JOE BLUE
INDIANAPOLIS, IN
NPI
1851906176
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN 86000347A)
Enumeration Date
2020-09-14
Last Update Date
2020-09-14
Business Address
LARRY JOE BLUE LAC, CHW, MATS, MTH
8202 CLEARVISTA PKWY
INDIANAPOLIS, IN 46256-1400
Phone number: 317-623-3007
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Mailing Address
LARRY JOE BLUE LAC, CHW, MATS, MTH
8202 CLEARVISTA PKWY
INDIANAPOLIS, IN 46256-1400
Phone number: 317-623-3007
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