| NPI | 1942515846 |
|---|---|
| Professional Name | TRACY BLACKMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C007924) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC 1823) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2013-02-27 |