Organization
IRENE T BLACKFORD PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE BLACKFORD PHD (PSYCHOLOGIST)
(814) 873-4141
Entity
Organization
Contact information
Practice address
410 CRANBERRY ST STE 130, ERIE, PA 16507-1071
(814) 873-4141
(814) 459-4673
Mailing address
410 CRANBERRY ST STE 130, ERIE, PA 16507-1071
(814) 873-4141
(814) 459-4673
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS006739
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
349983
MEDICARE PTAN
PA
Enumeration date
04/22/2014
Last updated
05/01/2026
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