Individual
MR. DEVON ANTHONY BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
100 OWINGS COURT, STE 8, REISTERSTOWN, MD 21136
(410) 526-7100
(410) 526-7138
Mailing address
10400 RIDGLAND ROAD, STE 1, COCKEYSVILLE, MD 21030
(410) 628-6120
(410) 628-9825
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA305
MD
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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