| Doctor Name: | MS. KATHELEN BLUE |
| NPI Number: | 1043283310 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.H.C. |
| License Number: | SW 7492 |
| Business Practice Address: | 137 Hospital Dr Fort Walton Beach, FL - 325485063 |
| Business Phone Number: | 8508337400 |
| Business Fax Number: | 8850833743 |
| Mailing Address: | 137 Hospital Dr Ne, FORT WALTON BEACH |
| State: | FL |
| Postal Code: | 325485063 |
| Phone Number: | 8508337400 |
| Fax Number: | 8850833743 |
| NPI Enumeration Date: | 02/08/2006 |
| NPI Last Update Date: | 11/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW 7492 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |