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Individual

CALEB BLACKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LGSW

Contact information

Practice address
1315 13TH AVE SE, DECATUR, AL 35601-4308
(256) 260-7361
(256) 260-7341
Mailing address
1316 SOMERVILLE RD SE, SUITE 1, DECATUR, AL 35601-4305
(256) 260-7361
(256) 341-0747

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3311G
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51148833
BLUE CROSS BLUE SHIELD OF AL
AL
Enumeration date
04/24/2014
Last updated
07/17/2014
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