Individual
BLONZINE JACQUELINE LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 HIDDEN VALLEY DR LOT A34, LEXINGTON, SC 29073-9295
(839) 213-4505
Mailing address
100 HIDDEN VALLEY DR LOT A34, LEXINGTON, SC 29073-9295
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
105326420
SC
Other
Enumeration date
02/18/2026
Last updated
02/18/2026
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