Individual
BRANDON BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 VERSAILLES BLVD, ALEXANDRIA, LA 71303-2351
(318) 449-4474
Mailing address
710 VERSAILLES BLVD, ALEXANDRIA, LA 71303-2351
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/24/2018
Last updated
09/12/2018
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