Individual
DR. ZACHARY BLACKHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2647
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
03046
KS
103TC0700X
Clinical Psychologist
2954
KS
103TC2200X
Clinical Child & Adolescent Psychologist
—
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Other
Enumeration date
08/06/2021
Last updated
04/04/2022
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