| Olivia Blassingame, | |
|
2434 S Eason Blvd, Tupelo, MS 38804-6942 | |
| (662) 640-4595 | |
| (662) 680-6416 |
| Full Name | Olivia Blassingame |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 2434 S Eason Blvd, Tupelo, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609423797 | NPI | - | NPPES |
| 00018203 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | P & S Clinic Ob-gyn Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538215546 PECOS PAC ID: 5890896252 Enrollment ID: O20070730000234 |
| Mailing Address | Practice Location Address |
|---|---|
| Olivia Blassingame, 2434 S Eason Blvd, Tupelo, MS 38804-6942 Ph: (662) 640-4595 | Olivia Blassingame, 2434 S Eason Blvd, Tupelo, MS 38804-6942 Ph: (662) 640-4595 |
Tiffany Brown, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 Fax: 662-680-6416 | |
Alyssa Bridges, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 | |
Caitlyn Capps, M.S.,NCC,LPC/MHSP-T Counselor Medicare: Not Enrolled in Medicare Practice Location: Po Box 2792, Tupelo, MS 38803 Phone: 731-472-0395 | |
Centrell Gardner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 | |
Kayla Harris, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-810-4125 | |
Keyaira Standifer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 | |
Mrs. Dorothy Elder Ford, Counselor Medicare: Not Enrolled in Medicare Practice Location: Region Iii Mental Health Center, 2434 South Eason Blvd, Tupelo, MS 38804 Phone: 662-844-1717 Fax: 662-680-6416 |