Individual
CASSONDRA BLACKSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16812 WARREN CREST CT, MOSELEY, VA 23120-2315
(804) 835-8970
Mailing address
16812 WARREN CREST CT, MOSELEY, VA 23120-2315
(804) 835-8970
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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