Provider Demographics
NPI:1457677437
Name:WENDT-BLASING, GINA M (LCMFT)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:WENDT-BLASING
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:M
Other - Last Name:WENDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:400 N WOODLAWN ST
Mailing Address - Street 2:#106
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-4338
Mailing Address - Country:US
Mailing Address - Phone:316-761-1061
Mailing Address - Fax:316-683-0780
Practice Address - Street 1:400 N WOODLAWN ST
Practice Address - Street 2:#106
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4338
Practice Address - Country:US
Practice Address - Phone:316-761-1061
Practice Address - Fax:316-683-0780
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS834106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist