Walisha M. Blackmore M.ed., Lpc

NPI #1649674219 in Port Arthur, Texas

Provider Information

NPI Number: 1649674219
Entity Type: Organization
Organization Name: Walisha M. Blackmore M.ed., Lpc
Primary Specialty: Counselor
Enumeration Date: Oct 10, 2014
Last Updated: Oct 10, 2014

Practice Location

Address: 2100 19TH ST
City: Port Arthur
State: Texas
ZIP Code: 77640-3859
Phone: (409) 344-2790

Authorized Official

Name: WALISHA BLACKMORE, LPC
Title: LICENSED PROFESSIONAL COUNSELOR
Phone: (409) 344-2790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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