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1356466049
RICHARD BLACKBURN
SHAWNEE, OK
NPI
1356466049
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 528)
Enumeration Date
2007-03-20
Last Update Date
2007-07-08
Business Address
-- RICHARD BLACKBURN LADC
1010 E 45TH ST
SHAWNEE, OK 74804-2202
Phone number: 405-273-1170
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Mailing Address
-- RICHARD BLACKBURN LADC
1010 E 45TH ST
SHAWNEE, OK 74804-2202
Phone number: 405-273-1170
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