Individual provider · Type 1 NPI

Miranda Brooke Blackburn

Mental Health Counselor · Evanston, IL

NPI number 1356199293 Active

Practice location

800 Austin St Ste 312
Evanston, IL 60202-3439

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1356199293

Miranda Brooke Blackburn's National Provider Identifier is 1356199293, issued on May 7, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Evanston, IL. The record was last updated on May 7, 2024.