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NPI Profile for REGINALD BLACKMON SR in CHARLOTTE, NC.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pastoral |
101YP1600X |
| NPI # | 1659802072 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/27/2017 | |
| Last updated | 03/27/2017 - About 9 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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REGINALD BLACKMON SR
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REGINALD BLACKMON SR