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1194830133
DERRICK K BLANTON
FRISCO, TX
NPI
1194830133
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: TX 32512)
Enumeration Date
2006-08-20
Last Update Date
2010-02-22
Business Address
Dr. DERRICK K BLANTON PYSD
13284 BUGATTI DR
FRISCO, TX 75034-0916
Phone number: 214-551-7104
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Mailing Address
Dr. DERRICK K BLANTON PYSD
13284 BUGATTI DR
FRISCO, TX 75034-0916
Phone number: 214-551-7104
Copy
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