Elizabeth Randell Blackburn, LMFT
Marriage & Family Therapist in Poulsbo, WA. Individual provider (NPI-1).
NPI number1104049568
StatusActive
Last updated in NPPESMay 1, 2018
Details
- NPI
- 1104049568
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth Randell Blackburn
- Credential
- LMFT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 11, 2007
- Last updated
- May 1, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | LF60554394 | WA | Yes |
| 106H00000X | Marriage & Family Therapist | MFT000939 | GA |
Practice location
20174 Front St NePoulsbo, WA 98370-7445
Phone 404-426-0486 · Fax 404-426-0486
Mailing address
20174 Front St NePoulsbo, WA 98370-7445
Phone 404-426-0486 · Fax 404-426-0486
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All 12 Marriage & Family Therapist providers in Poulsbo · All 821 providers in Poulsbo
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