Individual
NANCY BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CI
Contact information
Practice address
8402 CROSS PARK DR, AUSTIN, TX 78754-4595
(512) 697-8531
Mailing address
8402 CROSS PARK DR, AUSTIN, TX 78754-4595
(512) 697-8531
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12705
TX
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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