Provider Demographics
NPI:1972779635
Name:BLANKS, JANET ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:ELIZABETH
Last Name:BLANKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 PINE KNOB RD
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7003
Mailing Address - Country:US
Mailing Address - Phone:410-549-3663
Mailing Address - Fax:
Practice Address - Street 1:1780 PINE KNOB RD
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-7003
Practice Address - Country:US
Practice Address - Phone:410-549-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD003291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical