Individual
MS. HEATHER BLASINGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
1501 OLIVE ST, LAWRENCEVILLE, IL 62439-2269
(618) 943-3451
(618) 943-4368
Mailing address
PO BOX M, 504 MICAH DRIVE, OLNEY, IL 62450-0913
(618) 395-4306
(618) 395-4507
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/04/2007
Last updated
11/06/2007
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