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Individual

GUIDO BLACUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4600 S FOUR MILE RUN DR APT 410, ARLINGTON, VA 22204-3562
(703) 416-9246
Mailing address
5441 S MACADAM AVE STE A, PORTLAND, OR 97239-6106
(703) 472-2193

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0704016923
VA
101YM0800X
Mental Health Counselor
Primary
R10628
OR

Other

Enumeration date
06/03/2024
Last updated
01/17/2025
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