Individual
MRS. MIRIAM SAWAYA BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4800 MEMORIAL DR, WACO, TX 76711-1329
(254) 413-6486
Mailing address
4800 MEMORIAL DR, WACO, TX 76711-1329
(254) 413-6486
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
69702
TX
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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