Mark L Blodgett is a Clinical in Danville, Illinois. Mark L Blodgett practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mark L Blodgett is 1861597023. The last update date is 2013-04-24.
Mark L Blodgett's current location address is 1900 E Main St, Danville, Illinois. You can contact this provider via phone number 2175545195. The mailing address for Mark L Blodgett is 1900 E Main St, Danville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark L Blodgett |
|---|---|
| Address | 1900 E Main St, Danville, Illinois |
| Phone Number | 2175545195 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PSY.D |
NPI Number Detail
| NPI Number | 1861597023 |
|---|---|
| Provider Enumeration Date | 2006-09-13 |
| Last Updated Date | 2013-04-24 |
Provider Mailing Address Detail
| Address | 1900 E Main St |
|---|---|
| City | Danville |
| State | Illinois (IL) |
| Post Code | 618325100 |
| Phone Number | 2175545195 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 71003727 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identification code issued to Mark L Blodgett by the Centers for Medicare & Medicaid Services?
The Mark L Blodgett has been assigned the NPI (National Provider Identifier) 1861597023 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Mark L Blodgett's facilities are geographically located?
The facilities of Mark L Blodgett are physically situated at the following location: 1900 E Main St, Danville, IL, 618325100.
What is the Mark L Blodgett's specialty and taxonomy code?
The Mark L Blodgett's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did the Mark L Blodgett receive its 1861597023 assignment from the Centers for Medicare & Medicaid Services?
The Mark L Blodgett was assigned its 1861597023 by the Centers for Medicare & Medicaid Services on 2006-09-13.
When was the information pertaining to Mark L Blodgett most recently updated or revised?
The details related to Mark L Blodgett, including its address, specialty, and other relevant information, were last updated or revised on 2013-04-24.