| NPI | 1760799472 |
|---|---|
| Other Name | CHARLOTTE ELAINE BLAYLOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251B00000X Case Management (Licence: OK 251B00000X) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2010-09-02 |