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Individual
MS. SUSAN CORBETT BLACKWELL
Active
Individual
MS. SUSAN CORBETT BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003055
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
084592
SENTARA
VA
01
—
116527
ANTHEM
VA
01
—
289741
MAMSI
VA
05
—
5411807
—
VA
Enumeration date
07/26/2006
Last updated
10/18/2017
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