Individual
MR. GEORGE ALVA BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
134 W 1180 N, TOOELE, UT 84074-1483
(435) 228-4181
Mailing address
134 W 1180 N, TOOELE, UT 84074-1483
(435) 228-4181
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6672674-6004
UT
Other
Enumeration date
02/24/2011
Last updated
07/22/2015
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