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General NPI Number Information
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NPI Number | 1417407537
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Entity Type | Individual
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Provider Name | DAISY BLAGG PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 305 W WOODARD ST STE 201
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City | DENISON
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State | TX
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Zip | 75020-3136
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Country | US
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Telephone | 903-462-0032
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Fax | 903-496-0713
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Provider Business Mailing Address
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Address Line | 305 W WOODARD ST STE 201
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City | DENISON
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State | TX
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Zip | 75020-3136
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Country | US
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Telephone | 903-462-0032
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Fax | 903-496-0713
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 37419
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 32694
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 37419
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License Number State | TX
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