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Individual

DR. KYLA MACHELL BLALOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
3500 WESTGATE DR STE 900, DURHAM, NC 27707-2534
(919) 891-3096
Mailing address
3500 WESTGATE DR STE 900, DURHAM, NC 27707-2534

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
5393
NC
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
5393
NC

Other

Enumeration date
08/21/2018
Last updated
12/06/2023
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