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Individual
OLIVE BEAR BLACKWOOD
Active
Individual
OLIVE BEAR BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFTA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YP2500X
Professional Counselor
—
NULL
103TA0700X
Adult Development & Aging Psychologist
—
NULL
103TF0000X
Family Psychologist
—
NULL
106H00000X
Marriage & Family Therapist
Primary
10427A
NC
Other
Enumeration date
02/14/2024
Last updated
08/02/2024
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