Individual
KATIE BLICKENDERFER
Active
Individual
KATIE BLICKENDERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
007249
IA
104100000X
Social Worker
679
CO
1041C0700X
Clinical Social Worker
Primary
CSW09923008
CO
1041S0200X
School Social Worker
007249
IA
Other
Enumeration date
07/08/2009
Last updated
09/14/2012
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