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Individual

DR. AIMEE BLACKHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
622 BURGESSVILLE RD, RUSTON, LA 71270-5154
(318) 224-7223
(318) 414-1004
Mailing address
2804 LAKEVIEW DR, RUSTON, LA 71270-5254
(318) 243-0465

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1373
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
567123890
LA
Enumeration date
06/30/2014
Last updated
04/29/2026
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