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1780063941
TERRY CORNELIUS BLANKS
CHICAGO, IL
NPI
1780063941
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: IL 178001564)
Enumeration Date
2015-05-21
Last Update Date
2015-05-21
Business Address
Dr. TERRY CORNELIUS BLANKS
9548 S FOREST AVE
CHICAGO, IL 60628-1406
Phone number: 773-663-9676
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Mailing Address
Dr. TERRY CORNELIUS BLANKS
9548 S FOREST AVE
CHICAGO, IL 60628-1406
Phone number: 773-663-9676
Copy
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