Doctor Name: | MRS. JULIE ANN BLACKFORD |
NPI Number: | 1891896742 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2005038176 |
Business Practice Address: | 380 E Hwy Cc Suite A105 Nixa, MO - 65714 |
Business Phone Number: | 4177258810 |
Business Fax Number: | |
Mailing Address: | 645 N Jerico St, NIXA |
State: | MO |
Postal Code: | 657148963 |
Phone Number: | 4174999276 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2005038176 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |