Individual provider · Type 1 NPI

Mary Blackmon, CPRC

Addiction (Substance Use Disorder) Counselor · Canton, MI

NPI number 1033796107 Active

Practice location

50430 School House Rd
Canton, MI 48187-5910

Call (734) 431-2357 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1033796107

Mary Blackmon, CPRC's National Provider Identifier is 1033796107, issued on Mar 25, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Canton, MI. The record was last updated on Mar 25, 2021.