Individual
DEBORAH SHOGRY BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2090 EXECUTIVE HALL RD STE 170, CHARLESTON, SC 29407-8710
(843) 852-3633
Mailing address
2090 EXECUTIVE HALL RD STE 170, CHARLESTON, SC 29407-8710
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3225
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
05
—
190166
—
SC
Enumeration date
01/22/2007
Last updated
05/21/2008
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