Individual
JACQUELINE BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 MARKET ST # 619, GRANTSVILLE, WV 26147-4700
(304) 354-7017
Mailing address
105 MARKET ST # 619, GRANTSVILLE, WV 26147-4700
(304) 354-7017
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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