Individual
KYMBERLEE A BLACKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
777 N JEFFERSON ST, STE 408 PMB 1250, MILWAUKEE, WI 53202-1924
(414) 367-8494
Mailing address
777 N JEFFERSON ST, STE 408 PMB 1250, MILWAUKEE, WI 53202
(414) 367-8494
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11603-123
WI
1041C0700X
Clinical Social Worker
33009525A
IN
Other
Enumeration date
09/29/2021
Last updated
01/31/2025
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