Individual
EBONY BLAYLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13700 VETERANS MEMORIAL DR STE 450, HOUSTON, TX 77014-1034
(281) 508-4466
Mailing address
13700 VETERANS MEMORIAL DR STE 450, HOUSTON, TX 77014-1034
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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