| NPI | 1063835346 |
|---|---|
| Former Name | SHELLEY LYNN BLANCETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36329) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 19072) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2020-07-06 |