Individual
DR. COLETTE MARIE BLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1210 SOUTH BASCOM AVENUE, SUITE 122, SAN JOSE, CA 95128
(408) 706-0476
Mailing address
1210 SOUTH BASCOM AVENUE, SUITE 122, SAN JOSE, CA 95128
(408) 706-0476
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
21649
CA
Other
Enumeration date
08/04/2008
Last updated
08/29/2012
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