Individual
MS. JO ATLANTA BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L.C.P.C.
Contact information
Practice address
833 ANNAPOLIS RD, GAMBRILLS, MD 21054-1113
(410) 923-1236
Mailing address
833 ANNAPOLIS RD, GAMBRILLS, MD 21054-1113
(410) 923-1236
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC3086
MD
101YP2500X
Professional Counselor
Primary
LC3086
MD
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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