Individual
PERRY MASON BLANKENSHIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4687 POPLAR GAP RD., GLEN FORK, WV 25845
(304) 923-0449
Mailing address
6252 DAWES DR, KING GEORGE, VA 22485-7147
(304) 923-0449
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2202
WV
Other
Enumeration date
05/28/2019
Last updated
11/16/2022
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