Provider Demographics
NPI:1578071155
Name:BLUBAUGH, MAURYSA ROSEANNE (MA)
Entity Type:Individual
Prefix:MRS
First Name:MAURYSA
Middle Name:ROSEANNE
Last Name:BLUBAUGH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21712 MOUNTAIN HWY E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-7542
Mailing Address - Country:US
Mailing Address - Phone:253-331-0614
Mailing Address - Fax:
Practice Address - Street 1:21712 MOUNTAIN HWY E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-7542
Practice Address - Country:US
Practice Address - Phone:253-331-0614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor