WILLIS EDWIN BLACKMORE

TAOS, NM
NPI1386846715
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: NM  M-04831)
Enumeration Date2007-06-05
Last Update Date2012-02-01
Business Address
MR. WILLIS EDWIN BLACKMORE LMSW
1337 GUSDORF ROAD, SUITES E & F
TAOS, NM 87571-6489
Phone number: 575-758-4297
Mailing Address
MR. WILLIS EDWIN BLACKMORE LMSW
4787 NDCBU
TAOS, NM 87571-6032
Phone number: 505-737-0142
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