Individual
KAILYN BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1 JEFFERSON BARRACKS RD, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Mailing address
1 JEFFERSON BARRACKS RD, SAINT LOUIS, MO 63125-4181
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
124232
IA
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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