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1265824502
SHANTAE BLACKWELL
SICKLERVILLE, NJ
NPI
1265824502
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2015-02-24
Last Update Date
2015-02-24
Business Address
-- SHANTAE BLACKWELL
1422 KEARSLEY RD
SICKLERVILLE, NJ 08081-5205
Phone number: 856-308-5891
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Mailing Address
-- SHANTAE BLACKWELL
770 WOODLANE RD
WESTAMPTON, NJ 08060-3804
Phone number: 609-267-5928
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