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Individual

GUY BLACKSTONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC, CRC

Contact information

Practice address
2961 YARMOUTH GREENWAY DR STE 2, FITCHBURG, WI 53711-5809
(608) 504-3600
(608) 504-3700
Mailing address
4351 DONCASTER DR, MADISON, WI 53711-3717
(181) 598-1263

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4546-226
WI

Other

Enumeration date
12/18/2019
Last updated
06/22/2022
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