| NPI | 1528231495 |
|---|---|
| Former Name | ANN BLALOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AK 241492) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2025-08-05 |