Individual provider · Type 1 NPI
Grace M. Blackwood, LPC
Mental Health Counselor · Fairburn, GA
NPI number
1104071133
Active
Practice location
570 Windsor Way
Fairburn, GA 30213-6446
Fax (770) 703-7915
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | LPC004495 (GA) |
Mental Health Counselor: Definition to come...
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About NPI 1104071133
Grace M. Blackwood, LPC's National Provider Identifier is 1104071133, issued on Nov 18, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fairburn, GA. The record was last updated on Jan 26, 2016.