Individual
MR. E. LAWRENCE BLACKWELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, CAC
Contact information
Practice address
140 GLASTONBURY BLVD, SOMERSET SQ. 2ND FLOOR, GLASTONBURY, CT 06033-4402
(860) 212-5824
Mailing address
81 REDWOOD RD, MANCHESTER, CT 06040-6329
(860) 643-4684
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004581
CT
Other
Enumeration date
06/10/2009
Last updated
06/10/2009
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