Individual
JESSICA MARIE BLATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
809 PARK AVEUNE, BEAVER DAM, WI 53916
(920) 877-3171
Mailing address
817 CLEVELAND ST, KIEL, WI 53042-1232
(920) 306-3188
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
WI
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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