Individual
MRS. CAROLYN W BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
329 BATH RD, BRUNSWICK, ME 04011-2673
(207) 373-3070
(207) 373-3070
Mailing address
329 BATH RD, BRUNSWICK, ME 04011-2673
(207) 373-3070
(207) 373-3070
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC7316
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287340099
—
ME
Enumeration date
07/26/2005
Last updated
08/18/2011
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