Individual
MS. LUTRINO MARCELL BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. L.P.A.
Contact information
Practice address
217 S WILMINGTON ST, RALEIGH, NC 27601-1433
(919) 604-0918
(919) 847-6120
Mailing address
10716 LOWERY DR, RALEIGH, NC 27615-9714
(919) 604-0918
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2493
NC
103TC0700X
Clinical Psychologist
Primary
2493
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107073
—
NC
Enumeration date
04/02/2007
Last updated
04/09/2026
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