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Individual

DR. GARRET LANE BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
601 W TERRELL AVE, FORT WORTH, TX 76104-3243
(817) 702-3100
Mailing address
PO BOX 732973, DALLAS, TX 75373-3397

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
005356
AZ
103TC0700X
Clinical Psychologist
Primary
39801
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/10/2016
Last updated
03/27/2023
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