Provider Demographics
NPI:1326461328
Name:SPEARS, ADREANNA BARTHOLOME (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ADREANNA
Middle Name:BARTHOLOME
Last Name:SPEARS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 MAGNOLIA RIDGE CT
Mailing Address - Street 2:UNIT 203
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-6768
Mailing Address - Country:US
Mailing Address - Phone:502-439-3412
Mailing Address - Fax:502-365-2241
Practice Address - Street 1:8001 MAGNOLIA RIDGE CT
Practice Address - Street 2:UNIT 203
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-6768
Practice Address - Country:US
Practice Address - Phone:502-439-3412
Practice Address - Fax:502-365-2241
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1607103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical