Individual
GWENDOLYN YVONNE BLACKNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
3207 BROADWAY ST, APT. 3207, HOUSTON, TX 77017-2320
(281) 991-8668
(713) 236-0120
Mailing address
3207 BROADWAY ST, APT. 3207, HOUSTON, TX 77017-2320
(281) 991-8668
(713) 236-0120
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10653
TX
Other
Enumeration date
01/13/2011
Last updated
04/18/2014
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