JOHNNY BLACKWELL

SAN DIEGO, CA
NPI1558708016
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2013-05-23
Last Update Date2013-05-23
Business Address
-- JOHNNY BLACKWELL A.A.
3340 KEMPER ST STE., 103
SAN DIEGO, CA 92110-4906
Phone number: 619-758-1433
Mailing Address
-- JOHNNY BLACKWELL A.A.
4361 IDAHO ST #7
SAN DIEGO, CA 92104-1252
Phone number: 619-609-5300
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