Individual
MARSHA T BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
116 E 92ND ST, NEW YORK, NY 10128-1620
(646) 672-1105
Mailing address
116 E 92ND ST, NEW YORK, NY 10128-1620
(646) 672-1105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25045
NY
Other
Enumeration date
09/20/2010
Last updated
01/16/2015
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