Individual
MS. MIKKI G BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
108 RUTHERFORD ST, SUMMERVILLE, SC 29483
(843) 437-5994
(843) 875-2189
Mailing address
108 RUTHERFORD ST, SUMMERVILLE, SC 29483
(843) 437-5994
(843) 875-2189
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002387
SC
Other
Enumeration date
02/01/2007
Last updated
09/15/2022
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