Provider Demographics
NPI:1003117060
Name:BLATTNER, MEGHAN COLLEEN COMMINS (PHD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:COLLEEN COMMINS
Last Name:BLATTNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:COLLEEN
Other - Last Name:COMMINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:860 AHUALAKA LN
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4709
Mailing Address - Country:US
Mailing Address - Phone:410-870-9360
Mailing Address - Fax:
Practice Address - Street 1:1519 YORK RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-5611
Practice Address - Country:US
Practice Address - Phone:410-870-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MD06156103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor