Provider Demographics
NPI:1689072860
Name:BLASZAK, DEBRA DIANE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:DIANE
Last Name:BLASZAK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 E SPRAGUE AVE # 301
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4397
Mailing Address - Country:US
Mailing Address - Phone:509-720-6731
Mailing Address - Fax:
Practice Address - Street 1:540 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:TEKOA
Practice Address - State:WA
Practice Address - Zip Code:99033-9636
Practice Address - Country:US
Practice Address - Phone:509-720-6731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC07681101YP2500X
WA60399333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional