Blazina, Christopher Douglas

Blazina, Christopher Douglas is an individual health care provider with primary practice located at 6110 Shallowford Rd C O Crc, Chattanooga TN 37421-1615. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Blazina, Christopher Douglas can be contacted via phone (800) 632-6074.

Contact Information

Primary practice address
6110 Shallowford Rd C O Crc Chattanooga TN 37421-1615
Phone: (800) 632-6074
Fax: (866) 341-7509
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X P2642 Tennessee

Profile Details

NPI number 1275569774
LBN Legal business name Blazina, Christopher Douglas
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275569774 NPPES
Tennessee MEDICAID 3585928

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