Individual
JESSICA C BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 MAIN ST STE 122, MONROE, CT 06468-2872
(203) 261-7090
Mailing address
731 MAIN ST STE 122, MONROE, CT 06468-2872
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006539
CT
Other
Enumeration date
11/01/2007
Last updated
06/17/2020
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