Provider Demographics
NPI:1275141509
Name:BLANDFORD, OLIVIA (PHD)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:BLANDFORD
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 1:26113 OAK RIDGE DR STE C
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3494
Mailing Address - Country:US
Mailing Address - Phone:281-509-9533
Mailing Address - Fax:
Practice Address - Street 1:26113 OAK RIDGE DR STE C
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3494
Practice Address - Country:US
Practice Address - Phone:281-509-9533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38961103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical