| Doctor Name: | MS. SHANIDA ROXANA BLADES |
| NPI Number: | 1033381322 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 57745 |
| Business Practice Address: | 1201 E 9th Street Bonham, TX - 75418 |
| Business Phone Number: | 9075836597 |
| Business Fax Number: | |
| Mailing Address: | 1201 E 9th St, BONHAM |
| State: | TX |
| Postal Code: | 754184059 |
| Phone Number: | 9035836597 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2008 |
| NPI Last Update Date: | 02/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 57745 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |