Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1752 | KS |
Y | 103T00000X | Psychologist | 1752 | KS |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1752 | KS |
N | 103G00000X | Clinical Psychologist | 1752 | KS |
N | 103TC0700X | Clinical Psychologist | 1752 | KS |
NPI | 1093765661 |
---|---|
Provider Name | Dr. Tricia Denise Thornburgh Blatchford |
First Address | Arkansas City, KS 67005-9380 |
Second Address | Arkansas City, KS 67005-9380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 14/09/2018 |