Individual
MS. EVELYN NIDA BLANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
420 W 5TH AVE, FLINT, MI 48503-2445
(810) 496-5305
(810) 762-5234
Mailing address
2201 MONTCLAIR AVE, FLINT, MI 48503-2221
(810) 232-1689
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
315
WV
103TC0700X
Clinical Psychologist
Primary
6301007707
MI
103TC0700X
Clinical Psychologist
PS-007741-L
PA
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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