Individual
IRENE T BLACKFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
410 CRANBERRY ST STE 130, ERIE, PA 16507-1071
(814) 873-4141
(814) 459-4673
Mailing address
410 CRANBERRY ST STE 130, ERIE, PA 16507-1071
(814) 873-4141
(814) 459-4673
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS006739L
PA
103TC0700X
Clinical Psychologist
PS006739
PA
103TC0700X
Clinical Psychologist
Primary
PS006739L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
226411
MEDICARE PTAN
PA
Enumeration date
01/27/2011
Last updated
05/01/2026
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