Individual
BRYSON DALE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
725 N 12TH AVE, ARCADIA, FL 34266-8752
(863) 494-1242
(863) 491-0466
Mailing address
700 8TH AVE W STE 101, PALMETTO, FL 34221-4737
(941) 776-4000
(941) 845-4963
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW14904
FL
1041C0700X
Clinical Social Worker
SW14904
FL
Other
Enumeration date
11/07/2017
Last updated
07/21/2023
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