Individual
DR. RICHARD THOMAS BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2813 COLTSGATE RD, SUITE 201, CHARLOTTE, NC 28211-3798
(704) 491-9646
Mailing address
2813 COLTSGATE RD, SUITE 201, CHARLOTTE, NC 28211-3798
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1628
NC
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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