Individual
KENNETH E BLACKSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
295 MCCOWAN RD, FORSYTH, GA 31029-8684
(478) 960-4459
Mailing address
295 MCCOWAN RD, FORSYTH, GA 31029-8684
(478) 960-4459
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW010319
GA
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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