Individual
QUINTIN BLAYLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
495 DUNLOP LN, CLARKSVILLE, TN 37040-5295
(931) 347-6385
Mailing address
2743 ORANGE ST, RIVERSIDE, CA 92501-2538
(951) 788-9515
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1326201018
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/02/2020
Last updated
06/23/2025
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