Individual
DR. MARK L BLODGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5195
Mailing address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5195
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003727
IL
Other
Enumeration date
09/13/2006
Last updated
04/24/2013
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