Individual
COURTNEY NICOLE BLASSINGAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1305 LARK ST APT 13, TATUM, TX 75691-1757
(903) 646-7069
Mailing address
1305 LARK ST APT 13, TATUM, TX 75691-1757
(903) 646-7069
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104375
TX
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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