person
Brandy Lynn Blackwell, CADC1
Addiction (Substance Use Disorder) Counselor in Coburg, Oregon
NPI 1639716525

Brandy Lynn Blackwell is an Addiction (Substance Use Disorder) Counselor based in Coburg, OR and is specialized in Addiction (Substance Use Disorder). Brandy Lynn Blackwell practices in Coburg, OR and has the professional credentials of CADC1. The NPI Number for Brandy Lynn Blackwell is 1639716525 and holds a License No. 19-P-15 (Oregon).

The current practice location address for Brandy Lynn Blackwell is 91150 N Coburg Industrial Way, Coburg, OR and can be reached out via phone at 541-284-5673.

Location: 91150 N Coburg Industrial Way, Coburg, OR, 97408-1313
person
Provider Profile Details
NPI Number
1639716525
Provider Name
Brandy Lynn Blackwell
Credential
CADC1
Provider Entity Type
Individual
Gender
Female
Address
91150 N Coburg Industrial Way, Coburg, OR, 97408-1313
Phone Number
541-284-5673
Fax Number
Provider Enumeration Date
12/10/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1104934892 01 OR NPI
institution
Provider Business Practice Location Address Details
Address
91150 N Coburg Industrial Way
City
State
Zip
97408-1313
Phone Number
541-284-5673
Fax Number
person
Provider Business Mailing Address Details
Address
91150 N Coburg Industrial Way
City
State
Zip
97408-1313
Phone Number
541-284-5673
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
19-P-15 (Oregon)
Definition
Definition to come...
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