Individual
MR. DEALY E. BLACKSHEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5TH AND DIVISION STREETS, NOME, AK 99762
(907) 443-3289
(907) 443-5915
Mailing address
PO BOX 1802, 605 LOMENS STREET, NOME, AK 99762-1802
(907) 443-3289
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
635
AK
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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