Individual
MARILYN BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMHC, LPCI
Contact information
Practice address
1900 NE HIGHWAY 99W, STE H, MCMINNVILLE, OR 97128-2757
(503) 474-0194
Mailing address
1900 NE HIGHWAY 99W, STE H, MCMINNVILLE, OR 97128-2757
(503) 474-0194
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
R3388
OR
Other
Enumeration date
11/03/2014
Last updated
11/03/2014
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