NPI 1275569774 · live from the CMS NPI Registry
Christopher Douglas Blazina, Ph.D.
Psychologist in Chattanooga, TN. National Provider Identifier 1275569774, active.
NPI record
| NPI | 1275569774 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist 103T00000X |
| Practice location | 6110 Shallowford Rd, C O Crc, Chattanooga, TN 37421 |
| Practice phone | 800-632-6074 |
| Mailing address | 963 Mountain Valley Dr, Nashville, TN 37209 |
| Enumerated | June 25, 2006 |
| Last updated | July 9, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist primary | 103T00000X | P2642 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.