Individual
MS. CHRISTINE BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCIT, MS
Contact information
Practice address
6333 ODANA RD, MADISON, WI 53719-1170
(608) 270-2511
Mailing address
6333 ODANA RD, MADISON, WI 53719-1170
(608) 270-2511
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
261QM0801X
WI
Other
Enumeration date
12/15/2012
Last updated
12/15/2012
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