| NPI | 1215993746 |
|---|---|
| Former Name | KATHLEEN A. BLACKBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC000654) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA CAC number 0512) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2022-11-09 |