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Organization

HEATHER BLACKMORE MA LMFTA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. HEATHER ANNE BLACKMORE MA LMFTA (OWNER)
(360) 649-1238
Entity
Organization

Contact information

Practice address
374 NE MAX WILLIAM LOOP, POULSBO, WA 98370
(360) 649-1238
Mailing address
374 NE MAX WILLIAM LOOP, POULSBO, WA 98370-9169
(360) 649-1238

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
MG60354376
WA

Other

Enumeration date
07/15/2014
Last updated
07/15/2014
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