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Individual

CHRISTIAN A BLACKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
274 BOYDEN AVE, MAPLEWOOD, NJ 07040-3010
(201) 407-3977
Mailing address
4 S ORANGE AVE # 1164, SOUTH ORANGE, NJ 07079-1702

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SL06659700
NJ
1041S0200X
School Social Worker
44SL06659700
NJ

Other

Enumeration date
09/06/2022
Last updated
09/06/2022
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