Individual
GRACE M BLACKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
570 WINDSOR WAY, FAIRBURN, GA 30213-6446
(770) 365-3140
(770) 703-7915
Mailing address
570 WINDSOR WAY, FAIRBURN, GA 30213-6446
(770) 365-3140
(770) 703-7915
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC004495
GA
Other
Enumeration date
11/18/2008
Last updated
01/26/2016
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