JACK BLACKWELL

BOULDER, CO
NPI1417473190
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CO  nlc0103233)
Enumeration Date2017-08-15
Last Update Date2022-07-21
Business Address
JACK BLACKWELL
2373 VINEYARD PL
BOULDER, CO 80304-0649
Phone number: 720-275-2756
Mailing Address
JACK BLACKWELL
2373 VINEYARD PL
BOULDER, CO 80304-0649
Phone number: 720-275-2756
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