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1578926275
TEDDY BENJAMIN BLACKMON
VISALIA, CA
NPI
1578926275
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA C033960715)
Enumeration Date
2016-03-30
Last Update Date
2016-03-30
Business Address
-- TEDDY BENJAMIN BLACKMON CADC-CAS
1845 S COURT ST
VISALIA, CA 93277-5423
Phone number: 559-754-5593
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Mailing Address
-- TEDDY BENJAMIN BLACKMON CADC-CAS
1845 S COURT ST
VISALIA, CA 93277-5423
Phone number: 559-754-5593
Copy
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