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1427154699
PAMELA STUCKEY BLACKMON
CHARLOTTE, NC
NPI
1427154699
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC 1879)
Enumeration Date
2006-09-15
Last Update Date
2007-07-08
Business Address
-- PAMELA STUCKEY BLACKMON C.S.A.C.
5601 EXECUTIVE CENTER DR STE 101
CHARLOTTE, NC 28212-8841
Phone number: 704-561-0920
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Mailing Address
-- PAMELA STUCKEY BLACKMON C.S.A.C.
12504 SUSANNA DR
CHARLOTTE, NC 28214-6490
Phone number: 704-562-9414
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