Individual
CHRISTOPHER DOUGLAS BLAZINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6110 SHALLOWFORD RD, C O CRC, CHATTANOOGA, TN 37421-1615
(800) 632-6074
(866) 341-7509
Mailing address
963 MOUNTAIN VALLEY DR, NASHVILLE, TN 37209-5157
(615) 500-8574
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P2642
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3585928
—
TN
Enumeration date
06/25/2006
Last updated
07/09/2007
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