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General NPI Number Information
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NPI Number | 1851950851
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Entity Type | Individual
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Provider Name | OKSANA BLANKENSHIP
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Gender | Female
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 601 W TERRELL AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-3243
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Country | US
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Telephone | 308-632-8547
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Fax | 308-632-0135
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Provider Business Mailing Address
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Address Line | 200 W MAGNOLIA AVE STE 201
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City | FORT WORTH
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State | TX
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Zip | 76104-7657
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Country | US
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Telephone | 817-702-2977
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Fax | 817-702-2140
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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