Individual
MR. BENJAMIN AMOS BLACKMON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 MYRTLE ST STE 102, OAKLAND, CA 94607-2535
(510) 839-3800
Mailing address
111 MYRTLE ST STE 102, OAKLAND, CA 94607-2535
(510) 839-3800
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/11/2013
Last updated
02/11/2013
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