Individual
ELIZABETH JEAN BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1232 N PINELLAS AVE, TARPON SPRINGS, FL 34689
(727) 944-5171
(727) 944-5174
Mailing address
7415 FAIRFAX DRIVE, PORT RICHEY, FL 34668
(727) 847-0243
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW7512
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K4526
GROUP PROVIDER # MCARE B
—
Enumeration date
09/27/2006
Last updated
07/08/2007
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