Individual
ELIZABETH A BLANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
48 EAST AVE, WELLSBORO, PA 16901-1714
(570) 724-3549
Mailing address
253 LEONARDS LN, TROUT RUN, PA 17771-9242
(570) 772-2559
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CWO22322
PA
Other
Enumeration date
03/04/2019
Last updated
12/01/2021
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