Individual
DR. MICHELLE DAWN GAGNON BLODGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-5611
(954) 262-2276
Mailing address
12905 MILFORD CT, WELLINGTON, FL 33414-6235
(954) 262-5611
(954) 262-3557
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6028
FL
Other
Enumeration date
10/24/2006
Last updated
01/08/2013
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