Individual
WESLEY PETER BLITCHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2909 W STATE ROAD 434, SUITE 111, LONGWOOD, FL 32779-4459
(407) 774-0557
(407) 774-9329
Mailing address
2909 W STATE ROAD 434, SUITE 111, LONGWOOD, FL 32779-4459
(407) 774-0557
(407) 774-9329
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY 3223
FL
103T00000X
Psychologist
PY3223
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY 3223
FL
103TC0700X
Clinical Psychologist
Primary
PY 3223
FL
103TC1900X
Counseling Psychologist
PY 3223
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053110
VALUE OPTIONS
FL
01
—
593016832
TRICARE
FL
01
—
6126818
UNITED BEHAVIORAL HEALTH
FL
01
—
63893
CIGNA
FL
01
—
75237
BCBS FL
FL
Enumeration date
12/27/2006
Last updated
02/08/2011
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