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Individual

ARY BLACKMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
146 MCGEHEE DR, BATON ROUGE, LA 70815-5012
(225) 275-7273
Mailing address
20239 BUR OAK DR, ZACHARY, LA 70791-5351
(818) 438-5326

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5326
LA
Enumeration date
10/21/2019
Last updated
10/28/2019
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