| NPI | 1790273019 |
|---|---|
| Former Name | BRITTINI LYNN BLALOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 24405) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2020-04-03 |