Individual
MRS. AMY M WHITE BLAKESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
402 S KANSAS, CHANUTE, KS 66720
(620) 431-7890
(620) 431-7927
Mailing address
402 S KANSAS, CHANUTE, KS 66720
(620) 431-7890
(620) 431-7927
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP11450
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119749
BLUE SHIELD
KS
Enumeration date
01/17/2007
Last updated
07/08/2007
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