Individual
THERESA M BLAZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
208 N BROADWAY, STE 423 YELLOWSTONE COUNSELING CENTER, BILLINGS, MT 59101
(406) 896-8427
(406) 245-5980
Mailing address
PO BOX 51232, YELLOWSTONE BILLING SERVICES, BILLINGS, MT 59105
(406) 245-0453
(406) 245-7257
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1150
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0256955
—
MT
Enumeration date
10/31/2006
Last updated
07/08/2007
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