| NPI | 1497814735 |
|---|---|
| Former Name | KARISS TENILLE BLALOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 1954) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TN 1954) |
| 101YP2500X Counselor, Professional (Licence: SC 4653) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2008-04-08 |