| Doctor Name: | MARILYN YVETTE BLANKENSHIP |
| NPI Number: | 1659414811 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, BSN, SF |
| License Number: | |
| Business Practice Address: | 4119 Grand View Ct Rosedale, VA - 242803510 |
| Business Phone Number: | 2769716522 |
| Business Fax Number: | 2768801238 |
| Mailing Address: | 4119 Grand View Ct, ROSEDALE |
| State: | VA |
| Postal Code: | 242803510 |
| Phone Number: | 2769716522 |
| Fax Number: | 2768801238 |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320900000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |