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Individual

NADINE BLASE PSAREAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CADC II, ICADC,

Contact information

Practice address
1558 MARIETTA HWY STE 200, CANTON, GA 30114-3615
(770) 224-6825
(770) 224-6826
Mailing address
350 POPE CIR, CANTON, GA 30114-8418
(770) 224-6825
(770) 224-6826

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1369
GA
174H00000X
Health Educator
19-07-22-1180
GA

Other

Enumeration date
03/04/2020
Last updated
03/04/2020
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