Individual
CAROLYN BLUTHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA-ASSOCIATE
Contact information
Practice address
1508 DESHAUN RIDGE LANE, SUITE 204, AUSTIN, TX 78754
(512) 270-2309
Mailing address
1508 DESHAUN RIDGE LANE, SUITE 204, AUSTIN, TX 78754
(512) 270-2309
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99289
TX
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-20-135760
REGISTERED BEHAVIORAL TECHNICIAN (RBT)
TX
Enumeration date
12/21/2020
Last updated
05/08/2026
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