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Ms. Vida Lorraine Blakely, MFTT
Student in an Organized Health Care Education/Training Program in Modesto, California
NPI 1316116171

Vida Lorraine Blakely is a Student in an Organized Health Care Education/Training Program based in Manteca, CA. Vida Lorraine Blakely practices in Modesto, CA and has the professional credentials of MFTT. The NPI Number for Vida Lorraine Blakely is 1316116171 and holds a License No. (California).

The current practice location address for Vida Lorraine Blakely is 1700 Mchenry Village Way, Modesto, CA and can be reached out via phone at 209-526-1476 and via fax at 209-526-0908. You can also correspond with Vida Lorraine Blakely through the mailing address at 1227 COUNTRYSIDE LN, MANTECA, CA - 95337-6700 (mailing address contact number: 510-828-3037).

Location: 1700 Mchenry Village Way, Modesto, CA, 95337-6700
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316116171
Provider Name
Vida Lorraine Blakely
Credential
MFTT
Provider Entity Type
Individual
Gender
Female
Address
1700 Mchenry Village Way, Modesto, CA, 95337-6700
Phone Number
209-526-1476
Fax Number
209-526-0908
Provider Enumeration Date
02/26/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1700 Mchenry Village Way
City
Modesto
State
California
Zip
95350-4308
Phone Number
209-526-1476
Fax Number
209-526-0908
person
Provider Business Mailing Address Details
Address
1227 Countryside Ln
City
Manteca
State
California
Zip
95337-6700
Phone Number
510-828-3037
Fax Number
209-629-8790
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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