Individual
ALICIA BLACKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
17155 NEWHOPE ST STE L, FOUNTAIN VALLEY, CA 92708-4233
(714) 496-7789
Mailing address
467 62ND ST, NEWPORT BEACH, CA 92663-1903
(714) 496-7789
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
82978
CA
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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