Individual
SALLY BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7955 BIG BEND BLVD, SAINT LOUIS, MO 63119-2703
(314) 968-2216
(314) 968-2335
Mailing address
7955 BIG BEND BLVD, SAINT LOUIS, MO 63119-2703
(314) 968-2216
(314) 968-2335
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2002032317
MO
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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