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Organization
KATHERINE BLACKWELL, LCSW - LIFE SERVICES
Active
Organization
KATHERINE BLACKWELL, LCSW - LIFE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE BLACKWELL LCSW (MANAGER)
(352) 409-4077
Entity
Organization
Contact information
Practice address
2117 STEWART LN, MOUNT DORA, FL 32757-9507
(352) 409-4077
Mailing address
2117 STEWART LN, MOUNT DORA, FL 32757-9507
(352) 409-4077
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW9581
FL
Other
Enumeration date
10/12/2012
Last updated
10/12/2012
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