Individual
JOY BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCSP
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
10167526
IN
1041C0700X
Clinical Social Worker
34006185
IN
Other
Enumeration date
03/22/2011
Last updated
10/29/2024
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