Individual
JESSICA M BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4918 LONGCOURT TRCE SE, ATLANTA, GA 30339-1698
(404) 290-2345
Mailing address
4918 LONGCOURT TRCE SE, ATLANTA, GA 30339-1698
(404) 290-2345
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
171W00000X
Contractor
—
—
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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