Individual
PATRICIA BLANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1841 MADORA AVE, DOUGLAS, WY 82633-3057
(307) 358-2864
Mailing address
8 CRESTVIEW WAY, DOUGLAS, WY 82633-9003
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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