John Luther Blaylock
John Luther Blaylock is a Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, Arizona. Practices as a sole proprietor. Registered with an NPI since 2021.
- In the registry since
- 2021
Practice location Address checks out
2432 W Peoria AvePhoenix, AZ 85029-4726
Phone: (480) 431-5075
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Specialties & licences
| Mental Health Clinic/Center (Including Community Mental Health Center) (primary) | Taxonomy 261QM0801X |
|---|
Record details
| NPI number | 1467129478 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | August 26, 2021 |
| Last updated in NPPES | August 30, 2021 |
| Certification date | August 30, 2021 |
| Mailing address | 2432 W Peoria Ave, Phoenix, AZ 85029-4726 |
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