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Individual

STEPHANIE M BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED LMHC

Contact information

Practice address
45 EASTMAN STREET, SOUTH EASTON, MA 02375
(508) 238-5766
(508) 238-8045
Mailing address
45 EASTMAN STREET, SOUTH EASTON, MA 02375
(508) 238-5766
(508) 238-8045

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5679
MA

Other

Enumeration date
12/11/2006
Last updated
07/08/2007
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