Individual
REGINALD BLACKMON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 NORTH TRYON STREET, SUITE 1636, CHARLOTTE, NC 28202
(704) 620-0555
Mailing address
221 N CEDAR ST APT D, CHARLOTTE, NC 28202-1302
(704) 620-0555
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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