Individual
JENNIFER N/A BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC ASSOCIATE
Contact information
Practice address
3833 S STAPLES ST, CORPUS CHRISTI, TX 78411-5201
(361) 852-9665
Mailing address
467 UNIVERSITY DR, CORPUS CHRISTI, TX 78412-2743
(361) 765-5419
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
82944
TX
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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