Individual
MRS. AMY ELISA BLASDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
6700 W CENTRAL AVE STE 106, WICHITA, KS 67212
(316) 945-5200
(316) 945-5549
Mailing address
10118 W WESTPORT CT, WICHITA, KS 67212-6716
(316) 393-6919
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4076
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200565090B
—
KS
Enumeration date
06/26/2008
Last updated
09/27/2018
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