Individual
JACQUELINE BLODGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-A
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
84897
TX
101YP2500X
Professional Counselor
Primary
C8365
OR
Other
Enumeration date
12/12/2020
Last updated
10/17/2024
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