Individual
MRS. JESSICA LYNNE BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
420 N MAIN ST, BRISTOL, CT 06010-4923
(860) 583-5858
Mailing address
11 BOULDER RDG, SOUTHINGTON, CT 06489-1088
(860) 944-3207
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
007322
CT
Other
Enumeration date
01/10/2007
Last updated
12/16/2016
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