| Katherine Blackwell, Lcsw - Life Services | |
|
2117 Stewart Ln Mount Dora FL 32757-9507 | |
| (352) 409-4077 | |
| Not Available |
| Full Name | Katherine Blackwell, Lcsw - Life Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2117 Stewart Ln, Mount Dora, Florida |
| Authorized Official Name and Position | Katherine Blackwell (MANAGER) |
| Authorized Official Contact | 3524094077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine Blackwell, Lcsw - Life Services 2117 Stewart Ln Mount Dora FL 32757-9507 Ph: (352) 409-4077 | Katherine Blackwell, Lcsw - Life Services 2117 Stewart Ln Mount Dora FL 32757-9507 Ph: (352) 409-4077 |
| NPI Number | 1194077222 |
|---|---|
| Provider Enumeration Date | 10/12/2012 |
| Last Update Date | 10/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194077222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW9581 (Florida) | Primary |
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