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Individual

KRISTEN NICOLE BLANSETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5319 S LEWIS AVE, TULSA, OK 74105
(918) 832-7763
(918) 292-8250
Mailing address
5319 S LEWIS AVE, TULSA, OK 74105
(918) 832-7763
(918) 292-8250

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1154
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor
OK

Other

Enumeration date
02/18/2010
Last updated
05/07/2019
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