Becky Blatnick, BECKY BLATNICK

Individual provider Active NPI Marriage & Family Therapist · Crescent City, CA

NPI 1659433233 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1659433233
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC18052 (CA)
Practice address
422 9TH St
Crescent City, CA 95531-3430
Phone
(707) 464-8451
Fax
(707) 458-3074
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFC18052CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC18052 CA Yes

Addresses

Primary practice location

422 9TH St
Crescent City, CA 95531-3430

Mailing address

422 9TH St
Crescent City, CA 95531-3430
Phone (707) 464-8451

Other identifiers

IdentifierTypeStateIssuer
MFC18052OtherCALMFT LICENSE

Other names

  • Becky Blatnick Professional name

Other providers in Crescent City, CA

All providers in Crescent City, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.