NPI 1134316722

Lindsay Marie Blackwell

Practitioner Emotionally Disturbed Childrens' Residential Treatment Facility San Jose, CA

Practice location

Address: 463 Wooster Ave APT D23, San Jose, CA 95116-1096
Phone: (408) 712-0825

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1134316722
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Sep 2007
Record last updated: 27 Sep 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.