Provider Demographics
NPI:1922293679
Name:BLATTNER, LUISA CAROTENUTO (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUISA
Middle Name:CAROTENUTO
Last Name:BLATTNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12484 W 2ND DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-5011
Mailing Address - Country:US
Mailing Address - Phone:303-988-3014
Mailing Address - Fax:
Practice Address - Street 1:12484 W 2ND DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-5011
Practice Address - Country:US
Practice Address - Phone:303-988-3014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0344750103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool