Individual
ETHAN EVERETT BLASDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
421 E THOMAS AVE, STILLWATER, OK 74075-2600
(405) 372-2202
(405) 445-3780
Mailing address
421 E THOMAS AVE, STILLWATER, OK 74075-2600
(405) 372-2202
(405) 445-3780
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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