Holly Blalack is a Peer Specialist based in Tigard, OR. Holly Blalack practices in Tigard, OR. The NPI Number for Holly Blalack is 1942778139 and holds a License No. 18-CRM-045 (Oregon).
The current practice location address for Holly Blalack is 12540 Sw Main St Ste 202, Tigard, OR and can be reached out via phone at 503-906-9995.
Location: 12540 Sw Main St Ste 202, Tigard, OR, 97223-6198
Provider Profile Details
NPI Number
1942778139
Provider Name
Holly Blalack
Credential
Provider Entity Type
Individual
Gender
Female
Address
12540 Sw Main St Ste 202, Tigard, OR, 97223-6198
Phone Number
503-906-9995
Fax Number
Provider Enumeration Date
11/06/2018
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
12540 Sw Main St Ste 202
City
State
Zip
97223-6198
Phone Number
503-906-9995
Fax Number
Provider Business Mailing Address Details
Address
12540 Sw Main St Ste 202
City
State
Zip
97223-6198
Phone Number
503-906-9995
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
18-CRM-045 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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