MR. Peter Russell Blackman JR.

NPI #1609233907 in Bunkie, Louisiana

Provider Information

NPI Number: 1609233907
Entity Type: Individual
Name: MR. Peter Russell Blackman JR.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Jan 19, 2016
Last Updated: Jan 19, 2016

Practice Location

Address: 1140 SHIRLEY RD
City: Bunkie
State: Louisiana
ZIP Code: 71322-1545
Phone: (318) 346-8001

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary
Counselor - Mental Health — Mental Health	101YM0800X

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