Individual provider · Type 1 NPI

Brandy Lynn Blackwell, CADC 1

Addiction (Substance Use Disorder) Counselor · Coburg, OR

NPI number 1639716525 Active

Practice location

91150 N Coburg Industrial Way
Coburg, OR 97408-1313

Mailing address

PO Box 8549
Coburg, OR 97408-1313

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X19-P-15 (OR)

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

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About NPI 1639716525

Brandy Lynn Blackwell, CADC 1's National Provider Identifier is 1639716525, issued on Dec 10, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Coburg, OR. The record was last updated on Dec 10, 2019.