| Doctor Name: | MRS. GINGER BLACKSMITH |
| NPI Number: | 1407213135 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAC |
| License Number: | A1510139 |
| Business Practice Address: | 17 Business Park Dr Suite 13 Greenbrier, AR - 720589263 |
| Business Phone Number: | 5015817703 |
| Business Fax Number: | 5012046004 |
| Mailing Address: | 17 Business Park Dr, Suite 13 GREENBRIER |
| State: | AR |
| Postal Code: | 720589263 |
| Phone Number: | 5015817703 |
| Fax Number: | 5012046004 |
| NPI Enumeration Date: | 01/26/2016 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | A1510139 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |