Kelsey Lynne Blazicevich, LPC

NPI #1174149215 in Caldwell, Idaho

Provider Information

NPI Number: 1174149215
Entity Type: Individual
Name: Kelsey Lynne Blazicevich, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: LPC
Enumeration Date: Jun 24, 2020
Last Updated: Jun 24, 2020

Practice Location

Address: 923 GRANT ST
City: Caldwell
State: Idaho
ZIP Code: 83605-4137
Phone: (208) 585-3375

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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