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Individual
JONATHAN SCOTT BLANKENSHIP
Active
Individual
JONATHAN SCOTT BLANKENSHIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-R
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
052319-1
NY
1041C0700X
Clinical Social Worker
Primary
077458-R
NY
Other
Enumeration date
04/06/2010
Last updated
02/22/2018
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