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1962747519
MARIO BLACKSTON
BRIDGEVILLE, PA
NPI
1962747519
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-12-10
Last Update Date
2012-12-10
Business Address
-- MARIO BLACKSTON
316 STATION ST
BRIDGEVILLE, PA 15017-1833
Phone number: 412-221-1091
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Mailing Address
-- MARIO BLACKSTON
316 STATION ST
BRIDGEVILLE, PA 15017-1833
Phone number: 412-221-1091
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