Individual
KAHNI C BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
MGH REVERE HEALTHCARE CENTER, 300 OCEAN AVE., REVERE, MA 02151
(781) 485-6180
Mailing address
MGH REVERE HEALTHCARE CENTER, 300 OCEAN AVE., REVERE, MA 02151
(781) 485-6180
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
PSY-9439
MA
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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