Provider Demographics
NPI:1558808055
Name:BADOUR, CHRISTAL (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTAL
Middle Name:
Last Name:BADOUR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTAL
Other - Middle Name:
Other - Last Name:BADOUR HIRSCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:207-H KASTLE HALL UNIVERSITY OF KENTUCKY
Mailing Address - Street 2:UNIVERSITY OF KENTUCKY
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40506-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-3817
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-323-5500
Practice Address - Fax:859-323-0001
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY164538103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical