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Individual

MS. MUMINA BLACKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED.

Contact information

Practice address
5170 E. 65TH STREET, SUITE 107, INDIANAPOLIS, IN 46220
(317) 223-6057
(317) 845-8476
Mailing address
5170 E 65TH ST, SUITE 107, INDIANAPOLIS, IN 46220-4892
(317) 223-6057
(317) 845-8476

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
11/11/2010
Last updated
11/11/2010
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