NPI Profile for DIANE M BLACKWOOD in VERNON, CT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X | |||
Social Worker |
104100000X |
| NPI # | 1811407133 |
|
| Status | Active | |
| Credentials | LMSW LADC | |
| Entity | Individual | |
| Enumeration date | 10/02/2017 | |
| Last updated | 10/02/2017 - About 9 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DIANE M BLACKWOOD
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