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1982941647
JOHNNY LEE BLACKMON
TULARE, CA
NPI
1982941647
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 85029)
Enumeration Date
2013-01-14
Last Update Date
2023-12-13
Business Address
JOHNNY LEE BLACKMON LMFT
201 N K ST
TULARE, CA 93274-4005
Phone number: 559-687-0929
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Mailing Address
JOHNNY LEE BLACKMON LMFT
201 N K ST
TULARE, CA 93274-4005
Phone number: 559-687-0929
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